Purpose: To design and pilot a tailored intervention to enhance type 2 diabetes mellitus (T2DM) outcomes in an under-resourced Midwestern community. Design: One group pre-post feasibility study guided by Social Cognitive Theory and the Center for Latino Adolescent and Family Health's social determinants of health (SDOH) framework.
Methods: A community-health-academic partnership of three nonprofit organizations, nurses, researchers, and promotoras (community health workers) developed an intervention program to help people in their community prevent and manage T2DM and mitigate adverse SDOH. Seven small group, interactive sessions included low health literacy materials on diabetes-related self-care skills, healthy eating on a limited budget, and linkages to healthful resources and health care.
Findings: Participants (n = 31) had received a new diagnosis of pre-diabetes (n = 14) or T2DM (n = 17) at free community health screenings and were not engaged in care. All self-identified as Hispanic, had low acculturation scores, and were underinsured. After 12 weeks, hemoglobin A1C levels had significantly decreased for 66% of participants (p = 0.012). Body weight decreased from baseline to 12 weeks, although the change was not statistically significant. Self-efficacy for diabetes self-care increased from baseline to 12 weeks, notably on healthy eating (p = .012); exercising regularly (p = .035) and controlling diabetes/blood sugars (p = .003).
Conclusions: The intervention has promise but more research is needed to examine intervention efficacy and strategies to facilitate implementation.
Clinical evidence: Nurses play an important role in forging partnerships that can equip people in their communities with the knowledge, skills, and strategies to improve their T2DM health outcomes and to help them mitigate adverse SDOH.