"JUMPing into Diabetes Control": A Group-Setting Self-Empowerment Lifestyle Intervention among Diabetes Patients.

We examined the impact of a group-based self-empowerment intervention among diabetes patients, which uses multidisciplinary education, collaborative learning, peer support, and development of diabetes-specific social capital to improve glycemic control and weight management. Thirty-five patients who had primary care established at the Prisma Health Upstate, Internal Medicine Resident clinic and held the diagnosis of diabetes for longer than one year were recruited for our single-arm pilot intervention. Each group intervention session involved one to two internal medicine resident physician facilitators, a clinical diabetic educator, and 5-10 patients. Each session had a framework facilitated by the resident, with most of the discussion being patient-led, aiming to provide a collaborative learning environment and create a support group atmosphere to encourage self-empowerment. Patients' hemoglobin A1c level and body mass index (BMI) before the intervention and 3 to 6 months after completion were collected from the laboratory results obtained in the participants' routine clinic visits. All graduates from this three-week intervention were invited to attend monthly maintenance sessions, and we tracked the HgbA1c measures of 29 JUMP graduates one year after the intervention, even though 13 of the 29 chose not to participate in the monthly maintenance sessions. The pre-intervention HgbA1c level averaged 8.84%, whereas the post-intervention HgbA1c level averaged 7.81%. A paired t test showed that this pre-post difference of 1.03 percentage points was statistically significant (p = 0.0007). For BMI, there was an average decline of 0.78 from the pre-intervention mean value of 40.56 to the post-intervention mean value of 39.78 (p = 0.03). Among the 29 participants who agreed to participate in our follow-up measure of their HgbA1c status one year after the intervention, a paired t test showed that there was no significant difference between the post-JUMP measure and the follow-up measure (p = 0.808). There was no statistically significant difference between the HgbA1c level of those participating in the maintenance program and that of those not participating (post-intervention t test of between-group difference: p = 0.271; follow-up t test of between-group difference: p = 0.457). Our single-arm, pilot study of the three-week group intervention of self-empowerment shows promising results in glycemic control and weight loss. The short duration and small number of sessions expected could make it more feasible for implementation and dissemination as compared with popular intervention protocols that require much longer periods of attendance, if the effectiveness of this patient group-based self-empowerment approach can be further established by randomized controlled studies in the future.

Protective behaviors and high-risk drinking among entering college freshmen.

OBJECTIVES: To explore the use of protective behaviors to reduce risks associated with alcohol consumption among adolescents during the summer preceding college enrollment. METHODS: Survey data were collected in fall 2006 and 2007 that assessed demographic characteristics, drinking behaviors, and use of protective behaviors in the 3 months preceding the survey. RESULTS: Female participants reported using 4 out of 10 protective behaviors more often than did males, and using protective behaviors was significantly related to fewer negative drinking-related consequences. CONCLUSIONS: Findings highlight potential benefits of using protective behaviors and the need to promote effective behaviors.

Implications for breast and cervical cancer control for Latinas in the rural South: a review of the literature.

The Latino population has more than tripled in six southern US states. Little research exists describing the Latino population in the rural South and the unique cancer control needs of this group. This article reviews existing literature on Latinas with a focus on rural southern settlement processes and applicable breast and cervical cancer control research. Recommendations for effective cancer control programs include developing special outreach efforts conducted with monolingual Latinas, incorporating important cultural components and values related to family, spirituality, and community, and designing programs that incorporate low-literacy materials and messages or that do not require literacy to participate. Understanding the social, cultural, and economic issues that Latinas face is an important first step in designing culturally relevant breast and cervical cancer control.

Promoting success for at-risk African-American youth: perceived barriers and resources in using community-based success criteria.

A Delphi technique was used to assess service provider and community consensus on program elements essential for promoting the success of at-risk African American youth. The respondent group consisted of 54 subjects representing three broad groups: service agencies, community leaders and members, and school system participants. The study identified barriers to the use of community-derived success constructs, opportunities for collaboration between community members and service agencies in the development of programs, and the feasibility of incorporating success constructs into program development and delivery. Although consensus was achieved on key issues, individual variations between counties point to the necessity of targeting intervention programs to the unique problems and expectations found in each community.