University of Michigan

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Implementing Diabetes Interventions in Faith-Based Organizations: Praise Study

Location: Detroit, Michigan

The University of Michigan’s Department of Medical Education (DME) in an effort to implement effective and culturally-tailored approaches to diabetes self-management implemented a community-based participatory approach to addressing diabetes and distress.  In Michigan Type 2 diabetes, disproportionately affecting African Americans.  African American churches were selected as the community infrastructure for implementation of diabetes self-management education (DSME) and diabetes self-management support (DSMS). The Praise study builds on the work done by Michigan Center for Diabetes Translational Research and the Detroit Parish Nurse Network (DPNN) for African American churches in Detroit. Key features of the intervention included: 1) culturally-adapted diabetes self-management education (DSME), and 2) diabetes self-management support for distress. This intervention resulted in improvements in clinical outcome and increased diabetes self-management knowledge and skills.

Context

In Detroit, diabetes is the sixth leading cause of death. One-third of the population over the age of 50 have diabetes or prediabetes. Faith-based interventions have proven effective, although difficult to initiate. The study objectives were to examine the effectiveness of two novel approaches in addressing diabetes self-management support (DSMS) in church settings, DSMS with parish nurses and DSMS with parish nurses in combination with peer leaders. By using existing resources in the community, this initiative sought to build a sustainable model for DSMS in the community.

Action

The Praise study implemented a randomized control trial using the church as the variable to effect. Resulting accomplishments include DSMS meetings, DSME courses, and the provision of support services to participants.  Patients in the study set self-management goals, made progress towards goals by reducing HbA1c levels below 9% at the beginning of the project.  Baseline assessments were completed by 95 patients followed by 72 DSME intervention sessions across 8 churches.

Learnings

Findings suggest that actively working and communicating with community partners led to project success. Focus group data and provided important information about the implementation of DSME in faith-based settings. .Key learnings from this project include:

  • Peer leaders and adapting a curriculum to fit the context for implementation were factors that affected success.
  • The project coordinators provided capacity building and training opportunities to ensure peer leaders effectively engaged in the project and obtained improved health outcomes.
  • Rapid cycle feedback was useful for success in this study and collaboration to adjust components of the project allowed community flexibility and participation.
  • Future studies will consider higher risk patients as the target population for intervention to demonstrate improved health outcomes for these individuals.