Diabetes Care for African American and Latino Men: Findings From a Community-Based Intervention

Objectives. Among men, nationally, the highest prevalence of diagnosed diabetes is found in African American men (8%) and Latino men (7.1%) compared to white men (5.4%) (CDC, 2007). Discrepancies in quality of care and access have been reported for low-income African American and Latino men with diabetes. Research also indicates men have different health and health seeking behaviors than women, which may impact their participation in diabetes treatment and health management. This study sought to determine the effects of gender on participation in a community-based, culturally tailored diabetes lifestyle intervention, led by trained community health workers and conducted with African Americans and Latinos with type 2 diabetes.

Methods. This study utilized data from the REACH Detroit Partnership. Participants (N=344) were recruited from a community-based clinic and two hospitals. The primary outcome variables were withdrawal from the intervention (coded as 1=Withdrew; 0=Active), and number of intervention meetings attended. The primary independent variable was gender, which was coded as (1=Male; 2=Female). Education, age, race, employment and marital status served as controls.

Results. Bivariate comparisons revealed that 37.7 (n=57) women and 36.5 (n=19) men withdrew from the intervention. Men attended an average of 6.62 intervention meetings and women attended an average of 6.92 intervention meetings. Logistic regression analysis revealed that gender did not relate to the likelihood of intervention participation (p>.05; P=.166), or total intervention meetings attended (p>.05; P=.290), even after controlling for demographic differences for the overall sample.

Conclusions. A culturally tailored diabetes lifestyle intervention delivered by community health workers produced no gender differences in intervention participation. This contrasts with studies showing that men participate less frequently in traditional health care treatment. Future studies should replicate this finding and assess reasons for community health worker intervention acceptability to men in African American, Latino and other at-risk populations. The research also calls for social workers to discover ways they can work with and integrate intervention strategies that are community-based and utilize trained community residents.