Diabetes Medical Nutrition Therapy in Southeastern African American Women

Patient-Centered Outcomes Research Institute, Matthew Walker Comprehensive Health Center, Vanderbilt University

A two-arm randomized controlled trial design will be used. Participants will include 291 African American women with type 2 diabetes that are at risk for development and/or progression of diabetes complications. Both arms, diabetes medical nutrition therapy (MNT) and diabetes MNT plus motivational interviewing (MI), will include: 1) a 3-month active intervention period of six biweekly (every other week), group-based, trained nutritionist-facilitated sessions; 2) a 3-month maintenance intervention period, which will include one group-based maintenance support session; and 3) a 6-month inactive period (no contact). The differences between arms is the integration of culturally-adapted MI exercises during the diabetes MNT plus MI active and maintenance intervention periods.

Group-based MNT sessions that provide evidence-based dietary self-care information, behavioral skills, and goal setting related to managing carbohydrate and fat intake

Group-based support for dietary self-care motivation using culturally-adapted motivational interviewing exercise

Widely-utilized high performance liquid chromatography methods will be used to measure glycemic control from whole blood samples.

Widely-utilized high performance liquid chromatography methods will be used to measure glycemic control from whole blood samples.

Widely-utilized high performance liquid chromatography methods will be used to measure glycemic control from whole blood samples.

Widely-utilized high performance liquid chromatography methods will be used to measure glycemic control from whole blood samples.

Standard enzymatic laboratory procedures will be used to assess total cholesterol, HDL cholesterol, and triglycerides from whole blood. LDL will be calculated based on total cholesterol and HDL values.

Standard enzymatic laboratory procedures will be used to assess total cholesterol, HDL cholesterol, and triglycerides from whole blood. LDL will be calculated based on total cholesterol and HDL values.

Standard enzymatic laboratory procedures will be used to assess total cholesterol, HDL cholesterol, and triglycerides from whole blood. LDL will be calculated based on total cholesterol and HDL values.

Standard enzymatic laboratory procedures will be used to assess total cholesterol, HDL cholesterol, and triglycerides from whole blood. LDL will be calculated based on total cholesterol and HDL values.

A sphygmometer will be assessed to assess systolic blood pressure fifteen minutes after participant is in a seated position with their arm elevated.

A sphygmometer will be assessed to assess systolic blood pressure fifteen minutes after participant is in a seated position with their arm elevated.

A sphygmometer will be assessed to assess systolic blood pressure fifteen minutes after participant is in a seated position with their arm elevated.

A sphygmometer will be assessed to assess systolic blood pressure fifteen minutes after participant is in a seated position with their arm elevated.

Uses a Likert question format (n=12) and assesses attitudes and motivation for carbohydrate management.

Uses a Likert question format (n=12) and assesses attitudes and motivation for carbohydrate management.

Uses a Likert question format (n=12) and assesses attitudes and motivation for carbohydrate management.

Uses a Likert question format (n=12) and assesses attitudes and motivation for carbohydrate management.

Uses a Likert question format (n=12) and assesses attitudes and motivation for dietary fat management.

Uses a Likert question format (n=12) and assesses attitudes and motivation for dietary fat management.

Uses a Likert question format (n=12) and assesses attitudes and motivation for dietary fat management.

Uses a Likert question format (n=12) and assesses attitudes and motivation for dietary fat management.

Uses a Likert question (n=20) format and assesses patients' problems in applying various self-care areas, including dietary self-care skills.

Uses a Likert question (n=20) format and assesses patients' problems in applying various self-care areas, including dietary self-care skills.

Uses a Likert question (n=20) format and assesses patients' problems in applying various self-care areas, including dietary self-care skills.

Uses a Likert question (n=20) format and assesses patients' problems in applying various self-care areas, including dietary self-care skills.

Uses a Likert question (n=6) format and assesses self-efficacy in adhering to dietary recommendations and managing situations that make adherence challenging (e.g., social activities including few healthy food options.

Uses a Likert question (n=6) format and assesses self-efficacy in adhering to dietary recommendations and managing situations that make adherence challenging (e.g., social activities including few healthy food options.

Uses a Likert question (n=6) format and assesses self-efficacy in adhering to dietary recommendations and managing situations that make adherence challenging (e.g., social activities including few healthy food options.

Uses a Likert question (n=6) format and assesses self-efficacy in adhering to dietary recommendations and managing situations that make adherence challenging (e.g., social activities including few healthy food options.

Inclusion Criteria: African American Female Clinical diagnosis of type 2 diabetes for at least 6 months At risk for development and/or progression of diabetes complications (HbA1c ≥ 7.0% AND either systolic blood pressure ≥130, LDL cholesterol ≥ 100, or BMI ≥ 30). Exclusion Criteria: --Observed or diagnosed psychotic disorders