Project builds community support to improve health of diabetics

Duke is joining forces with African American churches in Durham on a new health research project aimed at tackling the diabetes epidemic from the ground up.

“Diabetes is on the rise across the country, driven largely by increasing obesity and sedentary lifestyles,” said Sherman James, Susan B. King Professor of Public Policy Studies and principal investigator on the project. “Poor people of color are among the most severely affected groups, and of course that includes many African Americans.”

Blacks are almost twice as likely as non-Hispanic whites to have diabetes. In Durham County, the death rate for minorities with diabetes is nearly three times that of non-Hispanic whites.

“Our goal is to develop community-based approaches to help diabetics better manage their health-approaches that are culturally appropriate and sustainable even after our research project concludes,” James said. “If we are successful, these methods could be applied in other communities, and help reverse this disturbing trend.”

Churches are often the hub of community activity in black neighborhoods, so it made sense to partner with them and their members to recruit diabetic adults for the African American Health Improvement Partnership (AAHIP), James said. And because empowering those most affected by the disease is a key goal, an economically and racially diverse community advisory board is providing suggestions and assistance. The board is led by chair Glenda Small, a vice president at N.C. Mutual Life Insurance, and vice chair Faye Tate-Williams, a psychiatric nurse

The multi-year project aims to recruit 200-250 participants and provide them with educational sessions on health issues such as nutrition, exercise, stress management and patient-doctor communication. At one recent session, participants estimated their daily intake of different food groups and learned the healthy definition of a “serving size.”

“People are loving it,” said Assistant Professor of Community Health Mina Silberberg, the project director. “The evaluations are really positive.”

Other integral parts of the project are small support groups of about a dozen diabetics and individual sessions with trained member of the community, in which participants set health goals and monitor their progress toward them.

The work is based on the idea that, in order to improve their health, people need appropriate knowledge, support, and resources, not only occasional visits to a medical clinic and intermittent contact with doctors. To learn if these interventions are working, the research team will periodically survey participants and measure height, weight, waist circumference, blood pressure and blood sugar. The data on blood glucose control will be compared with those of diabetics receiving their usual medical care through the Duke University Health System.

The project is funded primarily through a $1 million planning grant from the National Institutes of Health to the Division of Community Health. The project has partnered with the Community Health Coalition, a local nonprofit founded by family doctor Elaine Hart-Brothers.