Diabetes-related health disparities, especially for African Americans (AA) , underscore the need for effective, culturally tailored approaches to promote and sustain diabetes self-management support (DSMS) over time. The Praise study, a cluster randomized hybrid type II implementation trial recruited 21 AA churches, 28 peer leaders, 21 parish nurses, and 371 participants (100% AA, 73.8% female, 64±11.3 years of age) to determine the effectiveness of three DSMS approaches [Parish Nurse (PN) + Peer Leader (PL) DSMS vs. PN DSMS vs. PL DSMS], in comparison to enhanced usual care in improving and sustaining A1c and diabetes distress. Monthly DSMS groups were independently planned and facilitated by 28 trained PLs (100% African American, 18% male) and 14 trained PNs. A post-trial qualitative process evaluation was conducted to evaluate DSMS and ongoing support. Five focus groups were held (n=30) . Individual semi-structured interviews were completed with PLs and PNs (N=7) . Data were analyzed using the Rapid Analysis Process to generate themes from transcripts. Most participants were motivated to enroll in the Praise study to learn more about how to manage their diabetes. Others stated that poor health status (such as high A1C) and a need for accountability motivated them to join. PN and PL were driven to serve in these roles by a desire to educate and support other members of their community with diabetes in a structured format. Few concerns about the study were reported; however, the amount of time commitment was a common topic. Some participants encountered significant technology difficulties with attending remote sessions and a host of other issues related to the pandemic. Suggested improvements included:

  • 1) clear study expectations from the start;

  • 2) integrating exercise, and meal prep; and

  • 3) using of social media for recruitment.

AAs with T2D are motivated to engage in ongoing DSMS facilitated by PLs and PNs in church-settings. Improvements in training and support of PLs is needed.


J.M.Hawkins: None. A.M.Provenzano: None. R.Nwankwo: Advisory Panel; WW (Weight Watchers) . M.M.Funnell: n/a. K.A.Kloss: None. D.Hall: None. G.Piatt: None.

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