A randomized trial of an intervention to improve self-care behaviors of African-American women with type 2 diabetes: Impact on physical activity

Thomas C. Keyserling, Carmen D. Samuel-Hodge, Alice S. Ammerman, Barbara E. Ainsworth, Carlos F. Henríquez-Roldán, Tom A. Elasy, Anne H. Skelly, Larry F. Johnston, Shrikant I. Bangdiwala

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188 Scopus citations

Abstract

OBJECTIVE - To determine whether a culturally appropriate clinic- and community-based intervention for African-American women with type 2 diabetes will increase moderate-intensity physical activity (PA). RESEARCH DESIGN AND METHODS - In this randomized controlled trial conducted at seven practices in central North Carolina, 200 African-American women, ≥40 years of age with type 2 diabetes, were randomized to one of three treatment conditions: clinic and community (group A), clinic only (group B), or minimal intervention (group C). The clinic-based intervention (groups A and B) consisted of four monthly visits with a nutritionist who provided counseling to enhance PA and dietary intake that was tailored to baseline practices and attitudes; the community-based intervention (group A) consisted of three group sessions and 12 monthly phone calls from a peer counselor and was designed to provide social support and reinforce behavior change goals; and the minimal intervention (group C) consisted of educational pamphlets mailed to participants. The primary study outcome was the comparison of PA levels between groups assessed at 6 and 12 months by accelerometer, which was worn while awake for 7 days. RESULTS - Totals of 175 (88%) and 167 (84%) participants completed PA assessment at 6 and 12 months, respectively. For comparison of PA, the P value for overall group effect was 0.014. Comparing group A with C, the difference in the average adjusted mean for PA was 44.1 kcal/day (95% CI 13.1-75.1, P = 0.0055). Comparing group B with C, the difference in the average adjusted mean was 33.1 kcal/day (95% CI 3.3-62.8, P = 0.029). The intervention was acceptable to participants: 88% were very satisfied with clinic-based counseling to enhance PA, and 86% indicated that the peer counselor's role in the program was important. CONCLUSIONS - The intervention was associated with a modest enhancement of PA and was acceptable to participants.

Original languageEnglish (US)
Pages (from-to)1576-1583
Number of pages8
JournalDiabetes Care
Volume25
Issue number9
DOIs
StatePublished - Sep 1 2002

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

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    Keyserling, T. C., Samuel-Hodge, C. D., Ammerman, A. S., Ainsworth, B. E., Henríquez-Roldán, C. F., Elasy, T. A., Skelly, A. H., Johnston, L. F., & Bangdiwala, S. I. (2002). A randomized trial of an intervention to improve self-care behaviors of African-American women with type 2 diabetes: Impact on physical activity. Diabetes Care, 25(9), 1576-1583. https://doi.org/10.2337/diacare.25.9.1576