Document Type

DNP Project

Department

School of Nursing

Date of Degree

Summer 2022

Degree

Doctor of Nursing Practice (DNP)

Primary Advisor

Dr. Mercedes Echevarria; Dr. Cara Padovano

Keywords

diabetes prevention, community-based participatory research (CBPR), community health nursing, diabetes education

Abstract

Background: Prediabetes and diabetes continue to have a high disease burden in the United States (Lin et al., 2018). Many individuals are unaware of their glucose state or the impact impaired glucose can have on their quality adjusted life years and cost of living. The Centers for Disease Control and Prevention (CDC) has underscored the importance of decreasing the incidence of diabetes and has resources available. Still, many communities, particularly minority populations, can benefit from tailoring programs to their specific populations, where typical approaches may not be as beneficial (Joo & Liu, 2020). Additionally, Black American (BA) congregations often have a unique community-level soft infrastructure and psychological and sociological resources making them ideal sites for implementing education-based interventions (Kavanaugh et al., 2022; McNeill et al., 2018).).

Aim: This study aimed to initiate the tailoring of an evidence-based diabetes education program (DEP) entitled, Prevent T2 by the CDC (2020), to reduce the incidence of diabetes in BA members of a congregation by recognizing disparities in the Prevent T2 program for this community.

Objectives: (1) Collaborate with key members of a BA congregation to create a community advisory board (CAB) with at least six members; (2) Partner with the CAB members to prioritize goals of their diabetes education program (DEP); (3) Have the CAB members identify six topics from the CDC’s Prevent T2 program to review; (4) Evaluate themes discovered through CAB members’ discussions regarding cultural needs (5) Review themes with the congregation and determine feasibility of the DEP modifications within the congregation.

Methods: The researcher used Community Based Participatory Research (CBPR) principles to work with a community advisory board (CAB) at a local Mid-Atlantic church to review a CDC diabetes education program (DEP) in a Black American congregation. For content analysis, the interviews were transcribed, transcripts were read repeatedly, notes were made on the transcripts, and themes were identified.

Results: The six community advisory board members (CAB) reached a consensus that the diabetes education curriculum required modifications to be suitable for their community. Proposed modifications included three major themes: the importance of intergenerational involvement, the importance of community interaction/group wellness, and the importance of community activation through competition/engagement. There was consensus among the CAB members that the modified curriculum would be well received and appropriate for their church congregation.

Conclusions: The CAB members agreed that intergenerational involvement, community interaction/group wellness, and community activation through competition/engagement were missing from the DEP. The members were in agreement that modifying the diabetes education program according to the identified themes would be beneficial to their community. There are limitations to accurately representing the congregation, with only six community members involved. There are over twenty course options from the Prevent T2 curriculum, and only six were chosen to review to identify gaps within the community. The entire curriculum will be reviewed in a future study and submitted to the CDC as a culturally modified program.

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