Pilot Test of a Culturally Adapted Intervention (original) (raw)
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Perceptions of a Culturally Tailored Adapted Program to Prevent Type 2 Diabetes
International Journal of Diabetes and Clinical Research, 2015
Objective: To explore African and Caribbean immigrants' perceptions of a culturally tailored intervention to prevent type 2 diabetes. Methods: Using a purposive sampling scheme, 29 participants (26 women and 3 men, mean age 48 years and average length of residency of 22 years in Canada) participated in this study. The researchers used in-depth focus groups and individual surveys to collect qualitative data from participants. Following these interviews, participants individually reviewed the intervention and provided written feedback on their perceptions of the intervention. Data were analyzed using thematic analysis. Findings: Three themes emerged from the data: motivating factors to engage in physical activity and healthy eating, barriers that prohibit engaging in physical activity and increasing knowledge about food selection and modification of diet. In addition to the themes, participants had positive perceptions of the intervention. Eighty six percent rated the intervention as very useful and 83% were very satisfied with its contents. They reported that the intervention was culturally consistent with their beliefs, values and cultural practices in preventing type 2 diabetes. Conclusion: Perceptions of this culturally tailored intervention provided valuable evidence to assist the researchers in moving forward to the next level of research development such as evaluating the effectiveness of the intervention on the targeted groups' outcomes: self-care knowledge, performance of physical activity, healthy eating practices and self-efficacy.
(2011) Development and implementation of a culturally tailored diabetes intervention in primary care
Diabetes education for ethnic minorities should address variations in values underlying motivations, preferences, and behaviors of individuals within an ethnic group. This paper describes the development and implementation of a culturally tailored diabetes intervention for Puerto Ricans that can be delivered by a health care paraprofessional and implemented in routine clinical care. We describe a formative process, including interviews with providers, focus groups with patients and a series of multidisciplinary collaborative workshops used to inform intervention content. We highlight the intervention components and link them to a well-validated health behavior change model. Finally, we present support for the intervention's clinical effects, feasibility, and acceptability and conclude with implications and recommendations for practice. Lessons learned from this process should guide future educational efforts in routine clinical care.
Public Health Nutrition, 2021
Objective: To evaluate the cultural tailoring methods used in type 2 diabetes (T2D), prevention and management interventions for populations of Black African ancestry and to examine their effectiveness on measures of glycaemia. Design: Three databases were searched in October 2020; eligible studies used a randomised controlled trial (RCT) design to evaluate the effectiveness of culturally tailored lifestyle interventions compared with usual care for the prevention or management of T2D in adults of Black African ancestry. Cultural tailoring methods were evaluated using the Facilitator-Location-Language-Messaging (FiLLM) framework, whereby facilitator refers to delivery by individuals from the target community, language focuses on using native language or language appropriate to literacy levels, location refers to delivery in meaningful settings, and messaging is tailoring with relevant content and modes of delivery. Results: Sixteen RCT were identified, all from USA. The mean age of ...
Preventing Chronic Disease, 2015
Introduction Diabetes disproportionately affects underserved racial/ethnic groups in the United States. Diabetes prevention interventions positively influence health; however, further evaluation is necessary to determine what role culture plays in effective programming. We report on the status of research that examines cultural adaptations of diabetes prevention programs. Methods We conducted database searches in March and April 2014. We included studies that were conducted in the United States and that focused on diabetes prevention among African Americans, American Indians/Alaska Natives, Asian Americans/Pacific Islanders, and Latinos. Results A total of 58 studies were identified for review; 29 were excluded from evaluation. Few adaptations referenced or followed recommendations for cultural adaptation nor did they justify the content modifications by providing a rationale or evidence. Cultural elements unique to racial/ethnic populations were not assessed. Conclusion Future cultural adaptations should use recommended processes to ensure that culture's role in diabetes prevention-related behavioral changes contributes to research.
BMJ Open
IntroductionBlack British communities are disproportionately burdened by type 2 diabetes (T2D) and its complications. Tackling these inequalities is a priority for healthcare providers and patients. Culturally tailored diabetes education provides long-term benefits superior to standard care, but to date, such programmes have only been developed in the USA. The current programme of research aims to develop the Healthy Eating and Active Lifestyles for Diabetes (HEAL-D) culturally tailored T2D self-management programme for black British communities and to evaluate its delivery, acceptability and the feasibility of conducting a future effectiveness trial of HEAL-D.Methods and analysisInformed by Medical Research Council Complex Interventions guidance, this research will rigorously develop and evaluate the implementation of the HEAL-D intervention to understand the feasibility of conducting a full-scale effectiveness trial. In phase 1, the intervention will be developed. The intervention...
Journal of Nutrition & Food Sciences, 2018
Culturally competent health education can potentially save lives and overall improve quality of life. Health conditions such as diabetes, heart disease and blood pressure, if identified early, can possibly be controlled and less likely to become a major health problem. The present study was conducted to assess the impact of culturally competent health and nutrition education trainings on diabetes type II control directed to male Latinos/ Hispanics living in Atlanta, Georgia. United States. The five-week long education trainings were offered weekly to 50 volunteer participants that had been diagnosed with diabetes type II by their primary physician for over a year. Other than receiving diabetes prescription medication, the participants were not engaging in any other specific health activity intended to support diabetes type II control. Three other health factors were taken in consideration: height, weight, and Body Mass Index (BMI), which were measured at the beginning of each session. After each session, the participants were asked to implement the lessons learned at home, individually monitor blood glucose levels and record results in a tracking sheet provided. Results of the study include a stabilization and/or decline in glucose levels for the participants who reported to have continued their prescribed medications and implemented the knowledge learned in the education trainings. Weight loss was also noted the participants who were intentionally interested in losing weight as a result of the program. The results of the study thus conclude that culturally competent health and nutrition education trainings on diabetes type II control can make a significant impact in the health and nutritional status of male Latino/Hispanics.
(2010) A Brief Culturally Tailored Intervention for Puerto Ricans With Type 2 Diabetes
The information-motivation-behavioral skills (IMB) model of health behavior change informed the design of a brief, culturally tailored diabetes self-care intervention for Puerto Ricans with type 2 diabetes. Participants (n = 118) were recruited from an outpatient, primary care clinic at an urban hospital in the northeast United States. ANCOVA models evaluated intervention effects on food label reading, diet adherence, physical activity, and glycemic control (HbA1c). At follow-up, the intervention group was reading food labels and adhering to diet recommendations significantly more than the control group. Although the mean HbA1c values decreased in both groups (Intervention: 0.48% vs. Control: 0.27% absolute decrease), only the intervention group showed a significant improvement from baseline to follow-up (p < .008), corroborating improvements in diabetes self-care behaviors. Findings support the use of the IMB model to culturally tailor diabetes interventions and to enhance patients' knowledge, motivation, and behavior skills needed for self-care.
A Brief Culturally Tailored Intervention for Puerto Ricans With Type 2 Diabetes
Health Education & Behavior, 2010
The Information-Motivation-Behavioral Skills (IMB) model of health behavior change informed the design of a brief, culturally-tailored diabetes self-care intervention for Puerto Ricans with Type 2 diabetes. Participants (n = 118) were recruited from an outpatient, primary care clinic at an urban hospital in the northeast U.S. ANCOVA models evaluated intervention effects on food label reading, diet adherence, physical activity, and glycemic control (HbA1c). At follow-up, the intervention group was reading food labels and adhering to diet recommendations significantly more than the control group. While the mean HbA1c values decreased in both groups (Intervention: 0.48% vs. Control: 0.27% absolute decrease), only the intervention group showed a significant improvement from baseline to follow-up (p < .008) corroborating improvements in self-care behaviors. Findings support the use of the IMB model to culturally tailor diabetes interventions and to enhance patients' knowledge, motivation, and behavior skills needed for selfcare.
Effects of Acculturation on a Culturally Adapted Diabetes Intervention for Latinas
Health Psychology, 2012
Objective-To inform the refinement of a culturally adapted diabetes intervention, we evaluated acculturation's association with variables at several sequential steps: baseline measures of diet and physical activity, intervention engagement, putative mediators (problem solving and social resources), and outcomes (fat consumption and physical activity).
Health Beliefs and Practices of African Immigrants in Canada
Clinical Nursing Research, 2015
A purposive sample of 14 immigrants living in Ontario, Canada, participated in two focus groups. The researchers used semi-structured interviews to collect data and five themes emerged from the data: beliefs about diabetes were centered on diverse factors, preserving culture through food preferences and preparation, cultural practices to stay healthy, cultural practices determined number of servings of fruit and vegetables per day, and engaging in physical activity to stay healthy. Findings indicated how health beliefs and cultural practices influenced behavior in preventing type 2 diabetes (T2D). Future research should focus on other high-risk minority groups (South Asian, Caribbean, and Latin American) to examine their health beliefs and cultural practices and use these finding to develop best practice guidelines, which should be incorporated into culturally tailored interventions.