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, MD, MPH1,
- Carmen D. Samuel-Hodge, PHD, RD2,
- Alice S. Ammerman, DRPH, RD2,
- Barbara E. Ainsworth, PHD, MPH3,
- Carlos F. Henríquez-Roldán, MS45,
- Tom A. Elasy, MD, MPH6,
- Anne H. Skelly, RN, PHD7,
- Larry F. Johnston, MA8 and
- Shrikant I. Bangdiwala, PHD4
- 1Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- 2Department of Nutrition, Schools of Medicine and Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- 3Department of Epidemiology and Biostatistics, Department of Exercise Science and Prevention Research Center, School of Public Health, University of South Carolina, Columbia, South Carolina
- 4Department of Biostatistics, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- 5Department of Statistics, University of Valparaíso, Valparaíso, Chile
- 6Department of Medicine, School of Medicine, Vanderbilt University, Nashville, Tennessee
- 7School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- 8Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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.
- CDA, community diabetes advisor
- CHD, coronary heart disease
- HPLC, high-performance liquid chromatography
- PA, physical activity
- PAA, PA assessment
Footnotes
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Address correspondence and reprint requests to Thomas C. Keyserling, MD, MPH, CB no. 8140, 1700 Airport Rd., University of North Carolina at Chapel Hill, Chapel Hill, NC 27599. E-mail: thomas_keyserling{at}med.unc.edu.
Received for publication 6 September 2001 and accepted in revised form 19 April 2002.
A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.
- DIABETES CARE
