Extension‐Delivered Diabetes Program for Rural‐residing Latinos Improves Diabetes Self‐management, Self‐efficacy and Knowledge

Abstract

Listen

Translate article

Rural‐residing Latinos are at high diabetes risk due to limited access to healthcare services, high rates of overweight and obesity, and acculturation. Culturally‐sensitive diabetes self‐management education programs are needed to reduce the risk and severity of Type 2 diabetes among rural‐residing Latinos. Improvements in diabetes‐related self‐efficacy and knowledge can lead to improved diabetes self‐management outcomes. Latinos Living Well (LLW) was created using the Social Marketing Theory (SMT) and the Health Belief Model (HBM). SMT ensured the content was audience‐centered and culturally‐relevant. HBM constructs were addressed through facilitative discussion, cooking practicums, and hands‐on activities. LLW is made up of four two‐hour classes with culturally‐relevant food and physical activity examples, were taught in Spanish, and delivered through Cooperative Extension. This study evaluated the impact of LLW on diabetes self‐management practices, diabetes self‐efficacy, and diabetes knowledge. A convenience sample of rural‐residing Latino adults age 18+ in a Midwest state (n=120) were recruited, regardless of diabetes status, through collaborations with established community groups serving Latinos, radio commercials and print media, and word of mouth; 76 completed the program (63.3% completion rate). Participants completed a Spanish questionnaire comprised of validated tools, sociodemographic questions, and questions regarding diabetes status at the start of Class 1 (PRE) and the end of Class 4 (POST). Descriptive statistics analyzed sociodemographic data while paired‐samples t‐tests examined changes in diabetes self‐management, diabetes self‐efficacy and diabetes knowledge from PRE to POST. The majority were females (n=73; 97.3%), between the ages of 30 and 49 years (n=34; 51.6%), who were first generation immigrants (n=63; 87.5%). Two‐thirds (n=49; 65.3%) reported some history of a diabetes diagnosis. Significant increases were detected for diabetes self‐management practices (p<0.006), diabetes self‐efficacy (p<0.0001), and diabetes knowledge (p<0.004). These results suggest LLW is effective in improving diabetes self‐management practices, diabetes self‐efficacy, and diabetes knowledge outcomes among rural‐residing Latinos.Support or Funding InformationThis research was funded by the United States Department of Agriculture, National Institute of Food and Agriculture Rural Health and Safety Education Grant, #2014‐46100‐22349