Samuel-Hodge and coworkers developed and tested a culturally appropriate, church-based intervention to improve diabetes self-management. The study was a randomized trial conducted at 24 African American churches in central North Carolina. Churches were randomized to receive the special intervention (SI; 13 churches, 117 participants) or the minimal intervention (MI; 11 churches, 84 participants). The SI included an 8-month intensive phase, consisting of one individual counseling visit, 12 group sessions, monthly phone contacts, and three encouragement postcards, followed by a 4-month reinforcement phase including monthly phone contacts. The MI received standard educational pamphlets by mail. Outcomes were assessed at 8 and 12 months; the primary outcome was comparison of 8-month A1C levels. At baseline, the mean age was 59 years, A1C 7.8%, and body mass index 35.0 kg/m(2); 64% of participants were female. For the 174 (87%) participants returning for 8-month measures, mean A1C (adjusted for baseline and group randomization) was 7.4% for SI and 7.8% for MI, with a difference of 0.4% (P = .009). In a larger model adjusting for additional variables, the difference was 0.5% (P < .001). At 12 months, the difference between groups was not significant. Diabetes knowledge and diabetes-related quality of life significantly improved in the SI group compared with the MI group. Among SI participants completing an acceptability questionnaire, intervention components and materials were rated as highly acceptable.

WHAT THE STUDY MAY MEAN TO YOU AS A HEALTH CARE PROVIDER: The authors concluded that the church-based intervention was well received by participants and improved short-term metabolic control.

WHAT THE STUDY MAY MEAN TO YOU AS A PATIENT: The above study showed some promise. As noted by the investigators, the church-based intervention was well received by participants. However, no meaningful long-term data were gathered in the study. As repeatedly noted on this site, chronic health conditions require chronic self-management by patients. This suggests that the authors need to develop an intervention model that would lead to the long-term practice of self-management skills by patients. Several programs detailed in the diabetes literature suggest such self-management approaches have already been developed and tested.

CD Samuel-Hodge et al. A Randomized Trial of a Church-Based Diabetes Self-management Program for African Americans With Type 2 Diabetes. Diabetes Education, 2009;35:339-354.