Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Feb 4:31:100313.
doi: 10.1016/j.jcte.2023.100313. eCollection 2023 Mar.

A picture is worth a thousand words: A culturally-tailored video-based approach to diabetes education in Somali families of children with type 1 diabetes

Muna Sunni  1 , Jennifer Kyllo  2 , Carol Brunzell  1 , Janyce Majcozak  2 , Munira Osman  3 , Abdirahman M Dhunkal  4 , Antoinette Moran  1
Affiliations

A picture is worth a thousand words: A culturally-tailored video-based approach to diabetes education in Somali families of children with type 1 diabetes

Muna Sunni et al. J Clin Transl Endocrinol. .

Abstract

Objectives: Type 1 diabetes (T1D) is highly prevalent in Somali immigrant children and hemoglobin A1c (HbA1c) levels are elevated in this population compared to non-Hispanic Whites. Current self-management diabetes education has not been tailored to this population. We aimed to improve delivery of T1D education to Somali immigrants by developing and testing a culturally-appropriate video-based curriculum.

Methods: This cross-sectional study involved Somali youth ≤ 19 years with T1D followed at two pediatric tertiary centers in Minnesota. Ten Somali-language T1D education videos were developed (∼60 min for total program) based on core ADA curriculum and tailored to address cultural concerns and misconceptions. A diabetes knowledge questionnaire was administered to parents of all participants and to children aged ≥12 years. Pre- and post-educational session questionnaire mean scores were compared using a paired t-test to assess knowledge improvement immediately post-video education (primary endpoint) and retention at 3 months (secondary endpoint). HbA1c was measured pre- and 6 months post education (exploratory endpoint).

Results: Twenty-two Somali parents of 22 children participated (mean age 12.3 ± 4 years; 36 % female), 12 children ≥12 years. Diabetes knowledge scores significantly improved immediately post-video education compared to baseline (p = 0.012). This improvement persisted 3 months later (p = 0.0008). There was no significant change in mean HbA1c from baseline at 6 months post education (9.0 ± 1.5 % vs 9.3 ± 1.9; p = 0.6).

Conclusion: Culturally and linguistically tailoring diabetes education materials to African immigrants and delivering it audio-visually could improve effectiveness of diabetes education and increase knowledge and retention compared to simply translating standard diabetes education materials. The effect on HbA1c needs further study with a larger sample size.

Keywords: ADA, American Diabetes Association; CDE, Certified Diabetes Educator; CHCM, Children’s Hospitals and Clinics of Minnesota; Culture; Diabetes education; HbA1c; HbA1c, Hemoglobin A1c; SD, Standard deviation; Somali; T1D; T1D, Type 1 diabetes; UMN, University of Minnesota; US, United States.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Participant diabetes knowledge scores (n = 22) at baseline, 3- and 6-months post-video education. Participants were given points for each correct answer and no points for wrong answers or questions left blank. The highest possible score for the individual questionnaire was 10.
Fig. 2
Fig. 2
Proportion of correct questionnaire answers on various education topics at baseline, immediately-post and 3-months post video education.
See this image and copyright information in PMC

References

    1. Sunni M., Noble J.A., Yu L., Mahamed Z., Lane J.A., Dhunkal A.M., et al. Predominance of DR3 in Somali children with type 1 diabetes in the twin cities. Minnesota Pediatr Diab. 2017;18(2):136–142. doi: 10.1111/pedi.12369. [published Online First: 2016/02/09] - DOI - PubMed
    1. Maahs D.M., West N.A., Lawrence J.M., Mayer-Davis E.J. Epidemiology of type 1 diabetes. Endocrinol Metab Clin North Am. 2010;39(3):481–497. doi: 10.1016/j.ecl.2010.05.011. [published Online First: 2010/08/21] - DOI - PMC - PubMed
    1. Oilinki T., Otonkoski T., Ilonen J., Knip M., Miettinen P.J. Prevalence and characteristics of diabetes among Somali children and adolescents living in Helsinki. Finland Pediatr Diab. 2012;13(2):176–180. doi: 10.1111/j.1399-5448.2011.00783.x. [published Online First: 2011/05/21] - DOI - PubMed
    1. Wieland M.L., Morrison T.B., Cha S.S., Rahman A.S., Chaudhry R. Diabetes care among Somali immigrants and refugees. J Community Health. 2012;37(3):680–684. doi: 10.1007/s10900-011-9499-7. [published Online First: 2011/11/15] - DOI - PubMed
    1. Sunni M., Farah M., Hardie C., Dhunkal A.M., Abuzzahab M.J., Kyllo J.H., et al. Understanding cultural beliefs in families of Somali children with diabetes in the twin cities, Minnesota. J Community Health. 2015;40(4):827–833. 10.1007/s10900-015-0006-4. - PubMed