The Church’s Diabetes Self-Management Education Program

Why was the study done?

The main goal of this study was to analyze the effectiveness of a multi-faceted church-based diabetes self-management education program. The researchers assessed the impact of this intervention on patient outcomes among adult Hispanics diagnosed with diabetes type two (Baig et al., 2015). The researchers focused on the effect this approach had on glycemic control.

What is the sample size?

All participants were English or Spanish speaking adults who reported having diabetes type two. The patients provided written approval to participate in the study and were observed for about six months. Participants who were pregnant or had cancer or gestational diabetes were excluded from the research. Patients were recruited at such events as health fairs, educational classes, or church services. Eventually, one-hundred English and Spanish speaking adults with self-reported diabetes participated in the study.

Are instruments of the variables in the study clearly defined and reliable?

There are multiple variables in this study that were clearly defined and measured. The baseline characteristics were accurately collected and documented. Seventy-six percent of the patients stated that they were affiliated with the two churches that participated in the study (Baig et al., 2015). Three percent were in good health. Forty-one percent had an A1C level less than or equal to seven percent (Baig et al., 2015). After the eight-week intervention, the data were collected again. The final data were collected after 151 days from the end of the eight-week class, and enhanced usual care participants (50 people) were examined after 215 days from baseline (Baig et al., 2015). Other variables included meaning glycosylated hemoglobin (8.0%), mean low-density lipoprotein (108.1 mg/dL), mean systolic blood pressure (119.7 mmHg), mean diastolic blood pressure (mmHg), mean weight (78.5 kg), mean body mass index (31.7) and mean waist circumference (105.8 cm) (Baig et al., 2015). After three months of intervention, the A1C level decreased by 0.32 percent in participants from both groups. After six months of intervention, there was not any significant difference in change in an A1C level between the two arms (Baig et al., 2015). Similar results were obtained regarding changes in low-density lipoprotein, blood pressure, and weight. Because of the small number of participants, the researchers could not determine the adjusted change in weight between the two groups.

How was the data analyzed?

The researchers compared variables measured for the intervention and enhanced usual care groups. They used “the Student t-test for continuous variables and the Person x2 test for categorical variables at baseline” (Baig et al., 2015, p. 1484). To assess the impact of the intervention, the researchers applied linear mixed models. Every participant was examined within their groups. SAS version 9.2 was used for the analysis.

Were there any unusual events during the study?

Among the unusual events that occurred during the study, the most significant was the change in the class attendance level. Approximately thirty percent of participants did not attend classes at all. Many participants missed most classes. Therefore, it negatively affected the effectiveness of the intervention. Also, some data were collected via interviews, thus it might have been inaccurate. Also, certain populations were not included in the research. In the case of replicating this study, it is necessary to engage the pregnant, patients with cancer or gestational diabetes, and patients under the age of eighteen because the findings obtained from such a study might be applied to a wider population.

How do the results fit in with previous research in this area?

This is a comprehensive study that is based on the knowledge obtained from other works in this field. The authors used multiple sources to support their ideas. Most of the references are studies that address problems related to the development of diabetes, educational programs, diabetes management, risks, and long-term outcomes for Latin patients with diabetes, psychosocial and behavioral interventions, and many other topics pertinent to the issue discussed in the paper. For example, the authors supported their idea to recruit lay leaders who did not have diabetes with the reference to a work by Tang, Nwankwo, Whiten, and Oney, (2014) in which they discussed the outcomes of a church-based diabetes program. There are other examples. The idea to analyze the effectiveness of church-based education is also supported by a study by Baig et al. (2014). Also, the authors used the information from outside sources to develop the intervention. A study by Rothschild et al. (2014) inspired them to train lay leaders for the intervention classes. This approach is supported by other works as well. For example, in a study by Barrera, Toobert, and Strycker (2014), the authors emphasize the importance of lay leaders in educational programs. Therefore, the results presented in this work correspond to the existing data obtained by other researchers in this area.

What are the implications of the research for clinical practice?

The study addresses a very important clinical issue. The findings of this work are relevant to professionals who design educational programs for people with diabetes. The main implication that can be necessary for clinical practice is that a churched-based diabetes self-management intervention is not effective in reducing A1C. However, it helps participants lead a lifestyle that includes a healthy diet and physical exercise. Therefore, such interventions should become a part of the healthcare system to provide long-term support to patients.

References

Baig, A. A., Benitez, A., Locklin, C. A., Gao, Y., Lee, S. M., Quinn, M. T.,… Chin, M. H. (2015). Picture good health: A church-based self-management intervention among Latino adults with diabetes. Journal of General Internal Medicine, 30(10), 1481-1490.

Baig, A. A., Locklin, C. A., Wilkes, A. E., Oborski, D. D., Acevedo, J. C., Gorawara-Bhat, R.,… Chin, M. H. (2014). Integrating diabetes self-management interventions for Mexican-Americans into the catholic church setting. Journal of religion and health, 53(1), 105-118.

Barrera, M., Toobert, D. J., & Strycker, L. A. (2014). Relative contributions of naturalistic and constructed support: Two studies of women with type 2 diabetes. Journal of Behavioral Medicine, 37(1), 59-69.

Rothschild, S. K., Martin, M. A., Swider, S. M., Tumialán Lynas, C. M., Janssen, I., Avery, E. F., & Powell, L. H. (2014). Mexican American trial of community health workers: A randomized controlled trial of a community health worker intervention for Mexican Americans with type 2 diabetes mellitus. American Journal of Public Health, 104(8), 1540-1548.

Tang, T. S., Nwankwo, R., Whiten, Y., & Oney, C. (2014). Outcomes of a church-based diabetes prevention program delivered by peers: A feasibility study. The Diabetes Educator, 40(2), 223-230.