A Mixed-Methods, Randomized Clinical Trial to Examine Feasibility of a Mindfulness-Based Stress Management and Diabetes Risk Reduction Intervention for African Americans with Prediabetes

Authors

Cheryl L. Woods-Giscombe, University of North Carolina at Chapel Hill
Susan A. Gaylord, University of North Carolina at Chapel Hill
Yin Li, Emory University
Carrie E. Brintz, University of North Carolina at Chapel Hill
Shrikant I. Bangdiwala, University of North Carolina at Chapel Hill
John B. Buse, University of North Carolina at Chapel Hill
John D. Mann, University of North Carolina at Chapel Hill
Chanee Lynch, University of North Carolina at Chapel Hill
Pamela Phillips, University of North Carolina at Chapel Hill
Sunyata Smith, CUNY Lehman CollegeFollow
Karyn Leniek, Health Partners Central Minnesota Clinics
Laura Young, University of North Carolina at Chapel Hill
Saada Al-Barwani, University of North Carolina at Chapel Hill
Jeena Yoo, University of North Carolina at Chapel Hill
Keturah Faurot, University of North Carolina at Chapel Hill

Document Type

Article

Publication Date

8-14-2019

Abstract

African Americans have disproportionately high rates of stress-related conditions, including diabetes and diabetes-related morbidity. Psychological stress may negatively influence engagement in risk-reducing lifestyle changes (physical activity and healthy eating) and stress-related physiology that increase diabetes risk. ,is study examined the feasibility of conducting a randomized trial comparing a novel mindfulness-based stress management program combined with diabetes risk-reduction education versus a conventional diabetes risk-reduction education program among African American adults with prediabetes and self-reported life stress. Participants were recruited in collaboration with community partners and randomized to the mindfulness- based diabetes risk-reduction education program for prediabetes (MPD; n = 38) or the conventional diabetes risk-reduction education program for prediabetes (CPD; n = 30). The mindfulness components were adapted from the Mindfulness-based Stress Reduction Program. The diabetes risk-reduction components were adapted from the Power to Prevent Program and the Diabetes Prevention Program. Groups met for eight weeks for 2.5 hours, with a half-day retreat and six-monthly boosters. Mixed-methods strategies were used to assess feasibility. Psychological, behavioral, and metabolic data were collected before the intervention and at three and six months postintervention to examine within-group change and feasibility of collecting such data in future clinical efficacy research. Participants reported acceptability, credibility, and cultural relevance of the intervention components. Enrollment of eligible participants (79%), intervention session attendance (76.5%), retention (90%), and postintervention data collection attendance (83%, 82%, and 78%, respectively) demonstrated feasibility, and qualitative data provided information to further enhance feasibility in future studies. Both groups exhibited an A1C reduction. MPD participants had reductions in perceived stress, BMI, calorie, carbohydrate and fat intake, and increases in spiritual well-being. Considering the high prevalence of diabetes and diabetes-related complications in African Americans, these novel findings provide promising guidance to develop a larger trial powered to examine efficacy of a mindfulness-based stress management and diabetes risk reduction education program for African Americans with prediabetes.

Comments

This work was originally published in Evidence-Based Complementary and Alternative Medicine, available at https://doi.org/10.1155/2019/3962623

This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.