The following article is a part of conference coverage from the 2021 American Association of Nurse Practitioners National Conference (AANP 2021), held virtually from June 15 to June 20, 2021. The team at the Clinical Advisor will be reporting on the latest news and research conducted by leading NPs. Check back for more from AANP 2021.
A culturally tailored shared medical appointment program on diabetes significantly improved Black patients’ confidence in self-care abilities and diabetes knowledge, according to findings presented at the 2021 American Association of Nurse Practitioners National Conference.
“An important aspect of developing a culturally tailored program is to include topic experts who are trusted by the population being served,” said study coauthor Adrienne Reddick, MSN, FNP-BC, DNP. “There is significant research suggesting that trust in the medical system is lower among patients belonging to cultural and ethnic minorities and that members of minority groups may be more receptive and open to instructors belonging to the same group.”
A total of 37 Black patients with T2D were enrolled in the program (mean age, 58 years), which was launched at the Healthy Living Center in Norfolk, Virginia.
The intervention consisted of a brief 1-on-1 appointment with a clinician during which time patients were provided with their most recent laboratory assessments and biometric data. The culturally tailored course was led by a Black instructor who addressed unique barriers and challenges Black patients with T2D experience and discussed culturally relevant foods.
Participants were tested before and after the intervention with the Self-Efficacy for Diabetes Survey (SEDS), Revised Michigan Diabetes Knowledge Test (DKT), and were asked about their satisfaction with the program.
Intervention Improved Diabetes Knowledge
Prior to the shared medical appointment, patients answered 51.2% of the DKT test correctly. After the intervention, the percentage of correct answers increased to 57.0% (t, -1.316; P =.197).
SEDS scores for perception of confidence in self-care abilities were significantly increased (P <.001) as was the patient’s perceived knowledge about diabetes (Z, -3.314; P =.001). The proportion of patients reporting that they had a low level of knowledge about their disease decreased from 30.3% to 6.1% after the intervention. Overall DKT score increased from baseline levels, but this difference did not reach statistical significant.
Patient-reported satisfaction scores were high with a mean overall program satisfaction score of 98.2%.
“The high levels of satisfaction with the program are encouraging and suggest that individuals may be open to a multisession model that could help narrow the gap between perceived and actual diabetes knowledge acquisition among participants,” Dr. Reddick said.
The most helpful or effective component of the class was reported to be the nutritional information (37.9%), teaching method (27.6%), facts about the pathophysiology of diabetes (20.7%), and information about diabetes management (13.8%).
This was a small, single center study and these results may not be generalizable to other populations, the authors noted.
For other nurse practitioners who are developing a similar program at their institution, Dr Reddick advised that “programs should integrate environmental, lifestyle, and psychosocial factors into the curriculum as consideration of cultural differences may aid in the facilitation of information uptake and enhance self-efficacy. Program developers and instructors must have intimate knowledge of the social determinants of health barriers faced by the population and specifically address strategies for overcoming them.”
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Reddick AL, Gray DC. Impact of culturally tailored shared medical appointments on diabetes self-care ability and knowledge in African Americans. Poster presented at: 2021 American Association of Nurse Practitioners National Conference; June 15-20, 2021. Poster 11.