Social determinants of type 2 diabetes and health in the United States.

Diabetes is the sixth leading cause of death in the United States. To date, most research and resulting clinical strategies have focused on the individual with short-term health improvements that have not been maintained over time. Researchers more recently have recognized the need to consider the social determinants of diabetes and health along with individual factors.

Enhancing diabetes self-care among rural African Americans with diabetes: results of a two-year culturally tailored intervention.

Purpose: The purpose of this study is to test the feasibility of conducting a community-based randomized controlled trial evaluating a culturally tailored community-based group diabetes self-management education (DSME) program among rural African Americans.

Methods: Thirty-two African American rural adults with type 2 diabetes were recruited and 25 adults were retained and participated in an interventional study designed to test the effectiveness of the "Taking Care of Sugar" DSME program for the 2-year follow-up. Participants were selected from rural central Virginia.

Recruitment of Rural African Americans for Research Projects: Lessons Learned.

Recruiting rural African Americans for research presents special problems because of cultural differences, the view of researchers as cultural "outsiders", and transportation problems. This paper reports successful strategies in recruiting rural African American adults with type 2 diabetes for research studies. The researchers tested recruitment strategies commonly used in research, such as flyers, advertisements in local newspapers and radio stations.

Culturally tailored intervention for rural African Americans with type 2 diabetes.

Purpose: The purpose of this pilot study was to evaluate a culturally tailored intervention for rural African Americans. Social Cognitive Theory provided the framework for the study.

Methods: Twenty-two participants were recruited and randomly assigned to either Group or Individual diabetes self-management (DSME).

Diabetes care among rural Americans.

The prevalence of diabetes in the United States is higher among those living in rural/ nonmetropolitan statistical areas than in urban centers. Managing this complex chronic illness is complicated by factors such as limited access to care, low socioeconomic status, aging, and membership in a racial or ethnic minority group. A review of the literature was conducted focusing on research about rural Americans with diabetes by searching databases of CINAHL, PubMed, and MEDLINE, and selecting articles in English that were published between 2000 and 2007.

Cranial electrical stimulation: potential use in reducing sleep and mood disturbances in persons with dementia and their family caregivers.

Family caregivers of persons with dementia and their care recipients frequently experience sleep and mood disturbances throughout their caregiving and disease trajectories. Because conventional pharmacologic treatments of sleep and mood disturbances pose numerous risks and adverse effects to elderly persons, the investigation of other interventions is warranted. As older adults use complementary and alternative medicine interventions for the relief of sleep and mood disturbances, cranial electrical stimulation, an energy-based complementary and alternative medicine, may be a viable intervention.

Stress management during pregnancy: designing and evaluating a mind-body intervention.

The objective of this 12-week study was to determine whether a relaxation-guided imagery (R-GI) intervention designed as a primary prevention strategy for stress management was perceived as beneficial to African American women during the second trimester of pregnancy. All participants documented perceived benefits of the R-GI intervention that included the following: (1) improved breathing; (2) ability to relax, clear one's mind, and become calm; (3) ability to channel and decrease stress; (4) release of anxiety; (5) use of R-GI throughout the day helped control anger and state of mind, leading to a smoother day; and (6) improved ability to fall and stay asleep.

Family interactions among African Americans diagnosed with type 2 diabetes.

Purpose: The purpose of this study was to examine the impact of family and friends on the management of persons with diabetes and their willingness to be involved in a culturally tailored program.

Methods: This qualitative study was based within a larger quasi-experimental study that focused on the impact of a culturally tailored group intervention compared with individual standard diabetes education on the outcomes of self-management and glycemic control among rural African Americans with type 2 diabetes. Twenty-one participants were randomly assigned to an individual education group or a culturally tailored intervention group.

Decisions about transfer from nursing home to emergency department.

Purpose: To describe how decisions occurred to transfer nursing home (NH) residents to emergency departments (EDs).

Design: Three nursing homes (NHs) in Virginia were selected based on geographic and ownership variability. The phenomenon of concern was the decision-making process culminating in the transfer of NH residents to EDs.

Stories of diagnosis from rural Blacks with diabetes.

Diabetes has a disproportionate impact on people of color, including Black Americans. An understanding of the perspectives of rural Blacks is needed to design effective programs of diabetes care. The purpose of this study was to examine the experience of being diagnosed with diabetes as described by rural Blacks.

"Working hard with it": self-management of type 2 diabetes by rural African Americans.

The specific aims of this study were to describe the experience of self-managing type 2 diabetes among rural dwelling African Americans, to identify facilitators and barriers to self-management, to describe the use of prescribed and alternative therapies, and to elicit recommendations for programs of diabetes care. Ten focus groups were held in 3 rural communities. Men and women were in separate groups with facilitators matched by race and gender.

"Plenty of sickness": descriptions by African Americans living in rural areas with type 2 diabetes.

Purpose: The purposes of this study were to (1) describe facilitators and barriers to self-care for African Americans with type 2 diabetes living in a rural community, (2) compare experiences of men and women, and (3) solicit recommendations for programs of care.

Methods: Focus groups with small numbers of men and women (n = 7) were held to explore facilitators and barriers to self-management. Groups were led by moderators of the same gender and race as participants.