Evaluation of a program to promote diabetes care via existing agencies in African American communities.

Some African Americans with (or at risk for) diabetes underutilize health care services. We report short-term results of a "training of trainers" workshop designed to address this problem. The training program includes culturally sensitive educational materials, including materials developed for the ADA's African American Program (AAP). Workshops were presented to a) the 1996 national meeting of the predominantly black National Missionary Baptist Convention's Nurses Guilds, b) a minority-owned, TN based managed care organization's "community outreach workers," and c) other interested community organizations. Evaluations were based on program satisfaction and an "intention to change" procedure that assessed participants' actions and the obstacles they faced 6 months later. Sixty-four group representatives from 13 states participated. They completed a satisfaction questionnaire and were asked to complete a form that asked them to check any of 12 diabetes-related actions (distributing ADA risk tests, offering AAP classes, etc.) they intended their church/community group to take within six months. Activities not listed could be added. Follow-up contact information was solicited. Satisfaction surveys were positive. 39 (61%) returned checklists with complete contact information. Intentions included: arrange for congregation/community group to take risk test (71% of respondents), distribute diabetes materials at community health fairs or church services (67%), present AAP modules (59%), promote healthy foods at pot luck suppers (56%) and arrange cooking or exercise classes (38%). Respondents were contacted by telephone 6 months post-workshop and asked whether they had fulfilled their intentions. Contact information for 6 (15%) was no longer valid, and we were unable to reach 7 others despite repeated attempts. Approximately 30% of intentions were fulfilled by nurses guild members, but less than 10% by other groups. Half of all fulfilled intentions occurred in a community served by an active ADA AAP Coalition. Barriers to fulfilling intentions included lack of time/support, group not ready to act or doing other programs, and failure to collaborate with the ADA or others for mutual assistance. Existing agencies, especially churches with nurses guilds, offer a means for promoting diabetes screening and awareness in African American communities. A training workshop was well received and influenced some participant groups' self-reported actions. Participants appear more likely to fulfill intentions to conduct diabetes-related programs when they collaborate with other churches, agencies and/or the ADA.