265523 Cardiovascular wellness education among older African Americans:3 year results using community involvement to lower health literacy barriers

Sunday, October 28, 2012

Elizabeth M. Bertera, MSW, PhD , School of Social Work, Howard University, Washington, DC, DC
Purpose: To test a culturally appropriate approach to diabetes and high blood pressure education among older African Americans. Background: Older minority adults with limited resources have higher risk of poor health outcomes. Educational materials for addressing risks and self-management often have limitations based on cultural or linguistic appropriateness. Design: A three-year pretest-post-test, non equivalent control group design was implemented. A community participatory model was used in 12 metropolitan area senior affordable housing facilities. The 3 hour sessions incorporated storytelling and Fotonovela traditions to deliver health messages to peers (N=212) using photo images and recorded dialogue from community volunteers. Comparison group members (N=217) completed surveys and received a delayed intervention. Respondents averaged 72 years of age, and were predominantly African American (88%) and female (77%). Self-Administered scales included: Stanford Diabetes Nutrition and Physical Activity Self Efficacy (Chronbach's Alpha=.91), Dietary Decision Making (.78), and Brief Health Literacy (.83). RESULTS: Results for diabetes and high blood pressure outcomes each showed significant pre-post intervention improvement in mean self-efficacy scores (p <.000) versus no change in comparison groups. Mean self-efficacy scores increased significantly more in lower compared to higher health literacy respondents (p<.01). CONCLUSION: Involving community members in delivering health messages to minority peers is an effective way of insuring cultural and linguistic relevance while increasing interest, especially for those with the lowest health literacy. Implications: Making this participatory approach more widely available has the potential to reduce learning barriers among older minority populations, which in turn could help reduce health disparities.

Learning Areas:
Administer health education strategies, interventions and programs
Assessment of individual and community needs for health education
Chronic disease management and prevention
Conduct evaluation related to programs, research, and other areas of practice
Diversity and culture
Public health or related research

Learning Objectives:
1. Describe how tailored messages can be created by working with affordable housing organizations, community volunteers, and readily available tools for materials production. 2. Assess how self-efficacy is measured to capture the domains of nutrition, physical activity, and self care behaviors. 3. Discuss how participants with lower health literacy levels at baseline actually benefited more from the educational intervention than higher literacy participants.

Keywords: Aging, African American

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal investigator on a 3 year federally funded grant focusing on educating older African Americans about Diabetes and High Blood Pressure
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.