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Randomized Controlled Trial
. 2014 May 29:11:E90.
doi: 10.5888/pcd11.130349.

A self-management intervention for African Americans with comorbid diabetes and hypertension: a pilot randomized controlled trial

Elizabeth B Lynch  1 , Rebecca Liebman  2 , Jennifer Ventrelle  2 , Elizabeth F Avery  2 , DeJuran Richardson  3
Affiliations
Randomized Controlled Trial

A self-management intervention for African Americans with comorbid diabetes and hypertension: a pilot randomized controlled trial

Elizabeth B Lynch et al. Prev Chronic Dis. .

Abstract

Introduction: The objective of this pilot 6-month randomized controlled trial was to determine the effectiveness of an intensive, community-based, group intervention that focused on diet, physical activity, and peer support for reducing weight among urban-dwelling African Americans with comorbid type 2 diabetes and hypertension.

Methods: Sixty-one participants were randomized into an intervention or control group. The 6-month intervention consisted of 18 group sessions led by a dietitian in a community setting and weekly telephone calls from a peer supporter. The intervention featured culturally tailored nutrition education, behavioral skills training, and social support focused on changes to diet and physical activity. The control group consisted of two 3-hour group sessions of diabetes self-management education taught by a community health worker. Outcome measures were assessed at baseline and 6 months. The primary outcome was achievement of a 5% weight reduction at 6 months. A secondary outcome was achievement of a 0.5 percentage-point reduction in hemoglobin A1c (HbA1c).

Results: Groups did not differ in achievement of the weight-loss goal. Intervention participants lost a mean of 2.8 kg (P = .01); control participants did not lose a significant amount of weight. A greater proportion of intervention (50.0%) than control (21.4%) participants reduced HbA1c by 0.5 percentage points or more at 6 months (P = .03).

Conclusion: The intervention was more effective than usual care (short-term diabetes education) at improving glycemic control, but not weight, in low-income African Americans with comorbid diabetes and hypertension. A community-based 6-month group class with culturally tailored education, behavioral skills training, and peer support can lead to a clinically significant reduction in HbA1c.

Trial registration: ClinicalTrials.gov NCT01244152.

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Figures

Figure
Figure
Recruitment, screening, and participation in LIFE intervention, Chicago, Illinois, 2009–2010.
See this image and copyright information in PMC

References

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