Culturally Competent Diabetes Intervention and Diet in Black Women with Type 2 Diabetes

Abstract

Background: Dietary modification is a key component of diabetes self-management; however, one of the most challenging for patients. Many factors and barriers have been linked to diet, including psychosocial and socioeconomic issues. Purpose: (1) Assess the effect of a culturally competent diabetes intervention on dietary intake in Black women with type 2 diabetes. (2) Examine relationships between psychosocial factors and dietary change. Methodology: The parent study, Self-Care Intervention for Black Women with Type 2 Diabetes, was an RCT evaluating a culturally competent diabetes program compared to traditional diabetes education and care. This secondary analysis examined dietary change at 0, 6, and 12 months by group Univariate statistics were used to describe the sample. Bivariate and multivariate analyses examined relationships between dietary change and psychosocial factors (education, income, emotional distress, support, knowledge, selfefficacy). Findings: Among all women (N1⁄452), there was a significant decrease in caloric intake between baseline and 6 months, sustained at 12 months; however no difference by group. Despite a decrease in total fat and saturated fat intake, the percentage of calories from fat remained above the recommended level (30%). Carbohydrate, sugar, and fiber also decreased, while protein increased. Change in calories was related to provider support for diet (p1⁄4 005). Self-efficacy was not significant; however, along with provider support, it added to the power of the model explaining change in calories (r1⁄401375;p1⁄4004). Provider support, self-efficacy, and emotional distress best explained change in fiber intake (r1⁄4182;p1⁄4003); however fiber decreased, which was not beneficial. Summary Concluding Statement: Dietary improvements occurred among the women and were sustained at one year Differences by treatment group were not significant, possibly due to sample size. Health care provider support for dietary self-management is clearly important in dietary change, along with self-efficacy. Ongoing provider support is vital for maintenance of dietary changes implemented during self-management programs. Arts in Alzheimer’s Care