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Successfully Managing Diabetes in a Community Setting: Evidence From the YMCA of Greater Richmond Diabetes Control
Briana Mezuk1,2,3, William Thornton4, Shawnita Sealy-Jefferson5
1Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan.
Abstract:
Purpose The purpose of this study was to describe how a community-academic partnership developed and implemented a shared goal of evaluating the impact of a large community-based diabetes self-management program on diabetes care and mental health outcomes. Methods Data came from the YMCA of Greater Richmond Diabetes Control Program (DCP), a 12-week, group-format self-management program led by lay health coaches. Adults with type 2 diabetes (N = 312) completed baseline assessments of sociodemographic characteristics, diabetes history, and mental health. Four outcomes were assessed pre- and post-DCP on 141 participants who completed the program: hemoglobin A1C (A1C), weight, depressive symptoms (Patient Health Questionnaire-8), and glucose monitoring. The team worked with a Community Advisory Board throughout the research process. Results The DCP had wide geographic reach, including lower-income neighborhoods. The average age of the participants was 53.9 years, 71.4% were female, and 69% were African American. During the DCP, A1C declined from 8.4% to 7.6% (P < .001), but weight was unchanged (229.2 vs 227.9, P < .282). During the DCP, the proportion of participants with clinically significant depressive symptoms declined from 32.4% to 15.5% (P < .001), and frequency of glucose monitoring significantly increased. Conclusions The YMCA of Greater Richmond DCP has wide reach into underserved populations throughout the metropolitan area. This program is effective at improving diabetes self-management and mental health. Findings have implications for supporting academic-community partnerships to address diabetes disparities.
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