Effective strategies for reaching high-risk minorities with diabetes.

The NDOP goals of enhancing diabetes awareness by increasing screening activities within select African American neighborhoods and involving residents in health promotion activities were met during the course of the project. The coalition focused on principles suggested for diabetes programs directed at African American communities, including involving a target audience, providing a service, empowering people, and respecting cultural diversity. The focus group mechanism facilitated the input of community members into the program design prior to implementation and insured their involvement throughout the project. The screening and education program fostered empowerment by increasing community residents' control, focusing on their strengths, and identifying personal health goals. Funding support from the New York State Department of Health and the American Association of Diabetes Educators' Research Foundation were both essential in implementing the program. The program was well received. Most of the participant evaluations rated the program as excellent or very good. The program sites, although demographically situated within identified African American communities, produced a greater number of Caucasian and Hispanic participants than expected. Although the older group of African American women constituted 25% of the total population screened, it did not reach the desired number of 300 participants. Future programs need to target sites where older African American women are more likely to be found in greater numbers. Key to the program's success was building strong partnerships with community leaders who served as cultural spokespersons for the initiative to ensure participation from the community. Developing this partnership proved to be more challenging than originally anticipated and required a respectful, persevering approach. Yet once the coalition achieved cohesion, the volunteer members were invaluable in planning and implementing program events. Community members eventually took charge of the coalition and organized programs that have extended beyond the 2-year period of the grant. The coalition continues to expand; members have been added and education programs at churches and community meetings are ongoing. Addressing the problem of diabetes in African American communities requires programs that are innovative, culturally and educationally appropriate, and presented regularly. Such ongoing efforts can increase the knowledge in African American communities and ultimately enhance the health outcomes of community members.