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

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.