Impact of Storytelling and Skill Building On Diabetes Self-Efficacy Among Community Dwelling Older African Americans

Older adults who are members of ethnic minority groups and have low socioeconomic levels are at the greatest risk for poor health outcomes. This study was undertaken to examine innovative and culturally appropriate strategies to improve knowledge, attitudes and practices (KAP) related to diabetes and high blood pressure control among older African American Medicare recipients. A staggered pretest-posttest, non-equivalent control group design was utilized in this study. The study was implemented in three phases, development of the intervention, field testing, and hypothesis testing. The research was conducted in senior citizen centers and senior housing facilities. A three-hour educational intervention was implemented featuring Talking Fotonovelas that provided educational information about self-management of diabetes and blood pressure control. Each session included photographs and dialogue that incorporated oral history and fotonovela traditions. Dialogues and images were comprised of community participants and tailored to the target audience. The story telling segment was supplemented with skill-building activities to increase self-efficacy of participants. Strategies to reduce barriers to behavior change identified by focus groups were incorporated in the intervention. Findings indicated significant improvement in diabetes self-efficacy scores and dietary decision making. Lessons learned and strategies found to be effective in promoting healthy lifestyles were identified.