Conquering Diabetes with Jesus- A Culturally Tailored Intervention for African Americans with Diabetes

cross-silhouette1

Complications from Diabetes include….

  • -eye complications (glaucoma, cataracts, etc.)
  • -foot complications
  • -skin complications
  • -high blood pressure
  • -hearing loss
  • -mental health problems
  • -oral health complications
  • -gastoparesis
  • -ketoacidosis
  • -nerve damage
  • -dangerously high blood sugar levels
  • -kidney disease
  • stroke, stress and other compications

(American Diabetes Association, 2013)

Why Do African Americans Need A Specific Intervention for Diabetes?

  • 19% of blacks over the age of 20 suffer from diabetes (American Diabetes Association 2013)
  • Diabetic Blacks are…

-50% more likely to develop blindness

-3-6 more times more likely to suffer from kidney disease

-3 times more likely to suffer an amputation

(American Diabetes Association 2013)

Although diseases like diabetes and asthma uniquely affect minorities, there are not many interventions that have been published that look at the issue from a cultural perspective (McManus & Savage 2010).

110311-health-diabetes

What Should Be Our Goal In Dealing With Diabetes in the Black Community?

  • Reduce the negative complications associated with Type 2 Diabetes in the Black Community
  • Show that culturally-tailored interventions are more effective in treating certain diseases in the black community

Faith-Based Interventions

There have been studies that have shown that interventions that center on the Christian Church can have positive improved outcomes for blacks with diabetes (Collins-McNeil et al., 2012; Newlin et. Al 2012).  An intervention in a faith setting seems like an appropriate venue due to the fact that is much easier to recruit participants in a venue such as a Church.

Self and Contrast Effect

Chiu and Hong (2004) explain the concept of the “Self and Contrast Effect.”  With this effect, the researchers explain “people who are primed with a social category tend to assimilate their response into the primed category”(Chiu & Hong, 2004, p. 796).   They explain that if a culture is primed in a certain manner, it can lead to people assimilating to these certain primes.  This can lead to both positive and negative outcome in a certain culture.  In this case it may be leading to negative health outcomes for black Americans.  If black people are constantly reminded of the fact that they are historically known for having an unhealthy diet and living and unhealthy diet, they may feel that they have to conform to their specific primed category.  In this case, the primed social category is blacks being associated with unhealthiness.

*Can we reverse this self and contrast effect into a positive outcome, instead of a negative one like unhealthiness?  Can we prime Black people to respond to the primed category of being healthy?  This intervention will seek to answer this question!

Previous Research on Blacks and Diabetes has been effective however there were a few shortcomings

  • Most research does not utilize a control group to compare and contrast effectiveness
  • Most have not included a prominent cognitive aspect to the intervention
  • Sample sizes are usually small
  • Lengths of session often are long in length

MY PROPOSED INTERVENTION

IV- Type of Treatment, DV-Body Weight, A1C Levels, Attendance

Experimental Groups

  • Faith-Based Intervention with a Cognitive Component-Takes place in the Church with Pastor Support, culturally-tailored activities (i.e.-Diabetes-friendly Soul Food Lessons), and open forum sessions.  It will also include a priming survey prior to the intervention.
  • Faith-Based Intervention without a Cognitive Component-The same structure as the intervention above except it will not include the priming survey
  • Clinic-Based Intervention with a Cognitive Component-It will be a clinic-based intervention devised by a local clinic, but it will include the priming survey prior to the intervention.  It will be culturally-neutral in nature.

Control Group

  • Clinic-Based Intervention-This too will be a culturally-neutral intervention, but it will also not include the priming survey.

*The priming survey will be a short True or False test about diabetes.  The purpose of this test is to increase African American’s self-efficacy in handling their diabetes.  Research by Ma et al. (2011) performed a similar sort of task and they produced positive results.

In my proposed intervention there will be 160 participants (40 participants in each group). Participants will be recruited from 4 different churches, and put in their intervention for that Church. (i.e.-Church A will partake in Intervention1, Church B will partake in Intervention2, etc.) All 4 groups will undergo their particular intervention for a span of a year meeting once a week.  Prior to the intervention there will be 2 clinical measure taken for all the patients- body weight and A1C levels.  The Intervention will last a year in length, and after the final intervention session, the clinical measurements will be measured again.  In addition to the clinical measurements, attendance will also be recorded.  All three of these mean measurements in each intervention will be compared with the control intervention (the strictly clinical intervention).

black-woman-on-scale

What’s Going to Happen?!?!?!

I hypothesize that the faith-based culturally-tailored interventions (both with and without the priming survey) will have significantly higher means in all three measurements in comparison to the control group, while the other clinical-based intervention, with the priming survey, will not have significantly higher means in all three measurements than the control group.

In the end I think the results will provide more evidence as to why culturally-tailored interventions show great potential to be groundbreaking in the field of medicine.  It will also provide evidence as to how different cognitive tools have the ability to aid in patient’s self-efficacy in dealing with medical care as well.

If you have diabetes, you’re not alone.

-For more information on specific diabetes information, visit the American Diabetes Association Website at Diabetes.org

-Many famous people of all cultural background have diabetes.  Take a look at this website to check them out! http://diabeteshealth.com/read/2008/12/17/5681/famous-people-with-diabetes/

If you have questions about this proposed intervention, comment on the post or email me at jonesk@kenyon.edu 

References

African Americans & Complications. (2013).  Diabetes.org. Retrieved November 11, 2013, from http://www.diabetes.org/living-with-diabetes/complications/african-americans-and-complications.html

Collins-McNeil, J., Edwards, C., Batch, B., Benbow, D., McDougald, C., & Sharpe, D. (2012). A culturally targeted self-management program for African Americans with type 2 diabetes mellitus. CJNR: Canadian Journal of Nursing Research44(4), 126-41.

Chiu, C. & Hong, Y. (2004)  Cultural processes: Basic principles. In A. W. Kruglanski, & E. T. Higgins (Eds.) Social psychology: Handbook of basic principles (pp. 785-804). New York, NY: Guilford.

Ma, M., Dollar, K. M., Kibler, J. L., Sarpong, D., & Samuels, D. (2011). The effects of priming on a public health campaign targeting cardiovascular risks. Prevention Science12(3), 333-338. doi:10.1007/s11121-011-0228-3

Mc Manus, V. V., & Savage, E. E. (2010). Cultural perspectives of interventions for managing diabetes and asthma in children and adolescents from ethnic minority groups. Child: Care, Health And Development, 36(5), 612-622. doi:10.1111/j.1365-2214.2010.01101.xImages

Newlin, K., Dyess, S., Allard, E., Chase, S., & D’Eramo Melkus, G. (2012). A methodological review of faith-based health promotion literature: Advancing the science to expand delivery of diabetes education to Black Americans.Journal Of Religion And Health51(4), 1075-1097. doi:10.1007/s10943-011-9481-9

Images

http://www.bet.com/news/health/photos/2012/11/nov-14-is-world-diabetes-day.html#!110311-health-diabetes

http://thegrio.com/2013/01/03/new-research-links-being-slightly-overweight-with-lower-rates-of-death/

http://mudpreacher.org/2012/04/24/because-of-the-cross-we-have-the-word/

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s