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AJPH First Look, published online ahead of print Jul 28, 2005
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September 2005, Vol 95, No. 9 | American Journal of Public Health 1552-1560
© 2005 American Public Health Association
DOI: 10.2105/AJPH.2005.066134

RESEARCH AND PRACTICE

Racial and Ethnic Approaches to Community Health (REACH) Detroit Partnership: Improving Diabetes-Related Outcomes Among African American and Latino Adults

Jacqueline Two Feathers, MPH, PhD, Edith C. Kieffer, PhD, Gloria Palmisano, MA, Mike Anderson, Brandy Sinco, MS, Nancy Janz, PhD, Michele Heisler, MD, Mike Spencer, MSW, PhD, Ricardo Guzman, MPH, MSW, Janice Thompson, PhD, Kimberlydawn Wisdom, MD, MS and Sherman A. James, PhD

Jacqueline Two Feathers and Nancy Janz are with the Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor. At the time of the study, Edith Kieffer, Brandy Sinco, and Sherman James were with the School of Public Health, University of Michigan, Ann Arbor. Edith Kieffer and Brandy Sinco were also with the School of Social Work, University of Michigan. Sherman James was also with Duke University, Durham, NC. Michele Heisler is with the Veterans Administration Ann Arbor Health System and the Department of Internal Medicine, University of Michigan. Mike Spencer is with the School of Social Work, University of Michigan. Ricardo Guzman, Gloria Palmisano, and Mike Anderson were with Community Health and Social Services, Detroit, Mich. Janice Thompson is at the Office of Native American Diabetes Programs, University of New Mexico, Albuquerque. At the time of the study, Kimberlydawn Wisdom was with the Henry Ford Health System, Detroit.

Correspondence: Requests for reprints should be sent to Jacqueline Two Feathers, 2723 Sierra Drive NE, Albuquerque, NM, 87110 (e-mail: jtwofea{at}umich.edu).

Objectives. We sought to determine the effects of a community-based, culturally tailored diabetes lifestyle intervention on risk factors for diabetes complications among African Americans and Latinos with type 2 diabetes.

Methods. One hundred fifty-one African American and Latino adults with diabetes were recruited from 3 health care systems in Detroit, Michigan, to participate in the Racial and Ethnic Approaches to Community Health (REACH) Detroit Partnership diabetes lifestyle intervention. The curriculum, delivered by trained community residents, was aimed at improving dietary, physical activity, and diabetes self-care behaviors. Baseline and postintervention levels of diabetes-specific quality-of-life, diet, physical activity, self-care knowledge and behaviors, and hemoglobin A1C were assessed.

Results. There were statistically significant improvements in postintervention dietary knowledge and behaviors and physical activity knowledge. A statistically significant improvement in A1C level was achieved among REACH Detroit program participants (P<.0001) compared with a group of patients with diabetes in the same health care system in which no significant changes were observed (P=.160).

Conclusions. A culturally tailored diabetes lifestyle intervention delivered by trained community residents produced significant improvement in dietary and diabetes self-care related knowledge and behaviors as well as important metabolic improvements.




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