Preparing old favorites with a healthy twist
The University of California (UC) Health Promotion Workgroup at UC Davis, which is part of the university’s cooperative extension program, is developing an education program on diabetes prevention for African-Americans. All of the specialists, advisors, and faculty involved in the project have been working with this population group and saw a need for the education, says Lucia Kaiser, PhD, RD, UC Davis Community Nutrition Specialist. (For a definition of the cooperative extension program, see editor’s note at the end of this article.)
Working with the public, members of the Health Promotion Workgroup consistently ask what issues people want to know more about. Kaiser even took a survey and found that people in this patient population wanted to know more about diabetes.
At the university, the workgroup assembled focus groups to determine what African-Americans needed to know and how to make the information culturally specific. When the participants were asked what they thought contributed to the high rate of diabetes among African-Americans, most of the conversation centered on poor dietary habits.
Another issue that came up in the discussion frequently was the lack of information available to them about diabetes prevention. They felt that their health care providers were not educating them on this topic, and they weren’t being screened for diabetes, says Kaiser.
Using the data from the focus groups, the Health Promotion Workgroup decided to emphasize education in two areas in their program. One area focuses on cooking and how to prepare the foods many African Americans prefer, in a healthy manner, to prevent diabetes or help manage it. "Because people talked quite a bit about dietary changes and the barriers that are involved, we thought we would spend a lot of time working with cooking techniques and getting those to be very appealing," says Kaiser.
Materials are being developed to help people learn how to get the kind of health care they want; however, this marketing campaign will be accompanied by small classes that cover the more difficult issues that people have, such as reducing risks for diabetes and managing the disease through diet.
The curriculum being developed for small-group classes pairs an informational component with a cooking demonstration. There will be three classes with the first covering general information about diabetes, such as the two types of the disease. The second class will cover how diabetes is managed and the importance of medical nutrition therapy that includes learning carbohydrate management. The third class will cover the community resources available, such as diabetes screening. All classes will have a cooking demonstration.
"The class participants may be involved in preparing the foods themselves. There certainly will be a lot of tasting and discussion on how to overcome family resistance to changing recipes," says Kaiser.
Most of the advisors participating in the project are African-Americans who have worked extensively with this cultural group so they know the types of foods often preferred. "They have suggested the kinds of recipes we need and we have been testing them with small groups of the target audience," says Kaiser.
The workgroup also is using another model for diabetes education created through the university cooperative extension program in West Virginia titled "Dining with Diabetes." "We decided that we could use what they have by adapting it and updating the information," says Kaiser.
The curriculum should be completed the fall of 2002, and the program then will be pilot tested in the different counties in California. Agencies in each county will be asked to recruit about 150 people for the pilot test. Before the first class begins, a survey will be given to participants with questions about dietary changes related to diabetes. One to three months later, a follow-up survey will be given to the same participants to see what types of dietary changes people have made.
"We won’t just focus on diet but look at other key indicators," says Kaiser. For example, as a result of the program, were they screened for diabetes, and did they encourage someone in their family to be screened as well?
A diabetes awareness education program designed by UC Davis targeting Latinos did help change behavior according to the data gathered from the follow-up surveys, she says. Participants were more likely to have encouraged someone else to be screened for diabetes, increased physical activity, and changed their dietary behavior, such as reducing fat in their diet.
Once completed, the program on diabetes prevention for African-Americans focusing on dietary changes will be available to any health care institution interested in purchasing it. The price has not yet been set, but university extension programs are usually sold at cost, says Kaiser.
(Editor’s note: The Cooperative Extension Service is a partnership of the U.S. Department of Agriculture, state land-grant universities, and local governments.)
For more information about the diabetes prevention program for African-Americans, contact:
- Lucia Kaiser, PhD, RD, UC Davis Community Nutrition Specialist, Department of Nutrition, University of California Davis, One Shields Ave., Davis, CA 95616.