243746 Project SEED (Screening and Education to Eliminate Disparities) – Dissemination of an evidence-based African-American diabetes curriculum

Monday, October 31, 2011: 3:30 PM

Crystal Wiley Cene, MD, MPH , School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
Laura Beth Haymore, MPH , Cecil G. Sheps Center for Health Services Research, UNC at Chapel Hill, Chapel Hill, NC
Stepheria Sallah, BS , Cecil G. Sheps Center for Health Services Research, University of North Carolina-Chapel Hill, Chapel Hill, NC
Danny Ellis, LPN, MBA, PhD-ABD , Project SEED, Together Transforming Lives, Inc., Enfield, NC
Shaketa Whitaker, BS, RN , Project SEED, Together Transforming Lives, Inc., Enfield, NC
Trinette Boone Langley, BS, MSW , Project SEED, Together Transforming Lives, Inc., Enfield, NC
Stacey Henderson, MEd , Dynasty Health Solutions, Roanoke Rapids, NC
Cordain Dancy , Project SEED, Together Transforming Lives, Inc., Enfield, NC
Giselle Corbie-Smith, MD, MSc , TraCS Community Engagement Core, University of North Carolina-Chapel Hill, Chapel Hill, NC
Background: Diabetes affects more than 20 million people with African Americans (AA) being disproportionately affected. Randomized clinical trials have proven the efficacy of lifestyle modifications to prevent diabetes. However, there is a continued need for successful dissemination of evidence-based intervention strategies into community settings. Our objective was to evaluate the effectiveness, potential public health impact, and suitability for dissemination of an evidence-based diabetes prevention educational curriculum using the Reach, Evaluation, Adoption, Implementation and Maintenance (Re-AIM) framework.

Methods: Through a community-academic partnership, trained community health workers facilitated a comprehensive 12-session curriculum focused on healthy eating and physical activity in 3 rural AA communities. We collected pre-/post-curriculum changes in participants' diabetes knowledge, healthy eating, self-reported physical activity and biomarkers (blood glucose, blood pressure, BMI).

Results: Reach: All participants (n = 104) were AA; 75% female; average age 57 yrs; 39% were at “high risk” for developing diabetes. Forty-four percent completed 75% of the sessions. Effectiveness: The mean diabetes knowledge score increased from 63% to79% (p<0.5). Adoption: Six church pastors are now offering healthier food options at church events and exercise programs. Implementation: Barriers to implementation included low literacy levels, allocation of space and time to schedule the program, and transportation difficulties for participants. Maintenance: There was no significant change in biomarkers.

Conclusion: We demonstrated successful delivery of an educational curriculum to high-risk AAs and churches are willing to commit to health-promoting modifications. While the educational curriculum did result in significant improvements in diabetes knowledge, it did not significantly improve participants' biomarkers.

Learning Areas:
Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Public health or related research

Learning Objectives:
1. Describe the RE-AIM framework 2. Discuss how to use the RE-AIM framework to collect formative data to evaluate the dissemination of intervention strategies. 3. Demonstrate the importance of disseminating evidence-based intervention strategies into real-world community settings.

Keywords: Faith Community, Health Disparities

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the Principal Investigator on the project and responsible for data collection and analysis.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.