Translating an evidence-based diabetes education approach into rural African- American communities: The "wisdom, power, control" program

Purpose. The aim of this exploratory study was to assess the efficacy of the "Wisdom, Power, Control" diabetes self-management education (DSME) program with regard to diabetes knowledge, self-efficacy, self-care, distress level, and A1C in an African-American population. Methods. A prospective, quasi-experimental, repeated-measure design was employed to measure these outcomes. Study participants were assessed at baseline, 6 weeks post-intervention, and at a 3-month A1C follow-up. Results. A total of 103 participants were recruited from the intervention counties, and 14 were identified from the control counties. At the post-test, participants in the intervention group reported a significantly higher level of diabetes knowledge (δ = 9.2%, P <0.0001), higher self-efficacy (δ = 0.60, P <0.0001), more self-care behaviors (δ = 0.48, P <0.0001), lower distress level (δ = -0.15, P = 0.05), and higher health status (δ = 0.49, P = <0.0001). About 56% of the intervention group completed all six classes, and 25% attended five classes. Conclusions. Findings from this study demonstrate the initial success of translating a culturally adapted DSME program into rural African-American communities. The study highlights important lessons learned in the process of implementing this type of program in a real-world setting with a minority population.