The purpose of a pilot study conducted by Steinhardt and coworkers was to determine the feasibility of offering the authors' Diabetes Coaching Program (DCP), adapted for African Americans, in a sample of African American adults with type 2 diabetes. The study used 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 women, 8 men) with type 2 diabetes; 12 subjects (6 women, 6 men) completed the program. The DCP included four weekly class sessions devoted to resilience education and diabetes self-management, followed by 8 biweekly support group meetings. Psychosocial process variables (resilience, coping strategies, diabetes empowerment), and proximal (perceived stress, depressive symptoms, diabetes self-management) and distal outcomes (body mass index [BMI], fasting blood glucose, HbA1C, lipidemia, blood pressure) were assessed at baseline and at 6 months after study entry. Qualitative data were collected at 8 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, low-density lipoprotein cholesterol, and systolic and diastolic blood pressure. Medium to large effect sizes were reported. Resilience, perceived stress, fasting blood glucose, and high-density lipoprotein 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.

WHAT THE STUDY MAY MEAN TO YOU AS A HEALTH CARE PROVIDER: The authors concluded that their 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 cardiovascular disease in the African American community. They also suggested that randomized experimental designs were needed to confirm these findings.

WHAT THE STUDY MAY MEAN TO YOU AS A PATIENT: Although this was a pilot study, the findings were robust enough to suggest that the investigators conduct a full-scale, randomized study of their program. Who knows, but down the road future results could be beneficial to you if you experience diabetes.

MA Steinhardt et al. A Resilience Intervention in African American Adults With Type 2 Diabetes: A Pilot Study of Efficacy. Diabetes Education, 2009;35:274-284.