Participatory evaluation of a Nashville community program to enhance physical activity and care among African-American women with type 2 diabetes

Background: African-American women in the East Bank area of Nashville, Tennessee experience disproportionately high rates of type 2 diabetes. Seventeen percent of residents do not own a vehicle and have transportation barriers. Culturally-sensitive approaches to addressing diabetes in East Bank are needed.

 

Intervention: United Neighborhood Health Services (UNHS) implemented the Women Connecting in the Community Program (WCCP) in an effort increase physical activity and promote diabetes self-management among African-American women. A patient-centered medical home model was used to deliver enhanced diabetes care to UNHS patients. Program components were delivered by a multi-disciplinary healthcare team and included individual assessment and culturally-sensitive counseling for participants on setting goals, developing strategies for physical activity and nutrition, and family or peer support. Barriers to physical activity were addressed through in-home access to a culturally-competent fitness instructor. This paper features the evaluation of the WCCP as part of the overall participatory evaluation of Bristol-Myers Squibb Foundation’s Together on Diabetes initiative.

 

Results/Lessons learned:

Implementation results demonstrated a marked increase in delivery of services when physical activity sessions were delivered to women within their homes. This change in service delivery was associated with increased participation in physical activity by program participants as well as a modest improvement in HbA1c levels.

 

Conclusion:

Modifying access to physical activity through in-home and culturally-competent providers can enhance opportunities for physical activity for African American women. Addressing the barriers to lifestyle change can help reduce the diabetes burden among populations experiencing health disparities.