519-P: “What Can I Eat?” Healthy Choices for American Indians and Alaska Natives with T2D: Randomized Wait-List Controlled Trial Outcomes from a Nutrition Diabetes Education Program

Abstract

“What Can I Eat? (WCIE) Healthy Choices for American Indians and Alaska Natives (AI/ANs) with T2D” is a 5-lesson diabetes nutrition education program culturally adapted for AI/ANs with T2D. Classes were taught synchronously via Zoom at 5 reservation-based or urban inter-tribal clinical sites nationwide in 2021. Classes were taught by registered dietitian nutritionists (RDN) and topics included the diabetes plate, sugar sweetened beverages, heart healthy choices, food label reading. Class activities included didactic sessions, hands-on interactive learning, physical activity, mindful eating, and goal setting. Participants were recruited through diabetes registries at each collaborating site and randomized to either the immediate or the wait list group. The former group started classes immediately upon randomization; the latter started classes 3 months after randomization. Participants (N=58) were AI/AN adults with T2D (baseline data: mean age 58.6 +/-11.1 years, 26% male; BMI 33.8 (+/- 7.1)) . Before participation, each enrollee received a “class kit” including class activity resources and tools to collect evaluation data (i.e., scale, A1C kit, blood pressure monitor, and paper impact surveys) . Classes 1-4 were taught weekly for 4 weeks; the 5th class was taught 3 months after class #1. Data were collected at 3 timepoints: baseline, 1 month (after class 4) and 3 month (after class 5) . Outcomes included diabetes self-efficacy, behavior (physical activity and diet) , and clinical measures (BMI, blood pressure, A1c) . Linear mixed models were used to assess intervention effects on changes in outcome measures from baseline. No significant changes from pre to post were observed in behavior or clinical outcomes. Compared to the wait list group, the immediate group had greater increase in self-efficacy for using the diabetes plate at 1 and 3 months (ps<0.01) and for making healthy food choices at 1 month (p=0.047) . Disclosure K.R.Moore: Consultant; Novo Nordisk. D.Pavli: None. H.Pontius: None. J.Yanson: None. L.Jiang: None. Ai/an wcie study group: n/a. S.A.Stotz: n/a. A.G.Brega: None. M.C.Mcnulty: None. I.Adedoyin: None. G.Austin: None. N.Couture: None. H.Garrow: None. N.O'banion: None. Funding American Diabetes Association (4-18-SMSC-01)