A Resilience Intervention in African American Adults with Type 2 Diabetes: A Pilot Study of Efficacy

The purpose of this pilot study was to determine the feasibility of offering our Diabetes Coaching Program (DCP), adapted for African Americans, in a sample of African American adults with type 2 diabetes. The study utilized a one-group, pretest-posttest design to test the acceptance and potential effectiveness of the DCP. Subjects were a convenience sample of 16 African Americans (8 females; 8 males) with type 2 diabetes; twelve subjects (6 females; 6 males) completed the program. The DCP included four weekly class sessions devoted to resilience education and diabetes self-management, followed by eight bi-weekly support group meetings. Psychosocial process variables (resilience, coping strategies, diabetes empowerment), and proximal (perceived stress, depressive symptoms, diabetes self-management) and distal outcomes (BMI, fasting blood glucose, HbA1c, lipidemia, blood pressure) were assessed at baseline and six-months post study entry. Qualitative data were collected at eight-months via a focus group conducted to examine the acceptability of the DCP. Preliminary paired t-tests indicated statistically significant improvements in diabetes empowerment, diabetes self-management, BMI, HbA1c, total cholesterol, LDL-cholesterol, and systolic and diastolic blood pressure. Medium to large effect sizes were reported. Resilience, perceived stress, fasting blood glucose, and HDL-cholesterol improved, but changes were not statistically significant. Focus group data confirmed that participants held positive opinions regarding the DCP and follow-up support group sessions, although they suggested an increase in program length from 4 to 8 weeks. The pilot study documented the feasibility and potential effectiveness of the DCP to enhance diabetes empowerment, diabetes self-management, and reductions in the progression of obesity, type 2 diabetes, and CVD in the African American community. Randomized experimental designs are needed to confirm these findings.

This study is available for download in PDF version here.

The project described was supported by grant number P30NR005051 from the National Institute of Nursing Research awarded to The University of Texas at Austin School of Nursing (MAS) and NIH RO1AG20651 (CAJ). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Nursing Research or the National Institutes of Health.

Many thanks to our wonderful participants in the Diabetes Coaching Program held at Olivet Baptist Church in East Austin... enjoy the pictures! (click on each for a full-size version)

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A long, healthy, and happy life is the result of making contributions, of having meaningful projects that are personally exciting and contribute to and bless the lives of others.
~Hans Selye