Theory-guided intervention for preventing diabetes-related amputations in African Americans.

A disproportionate number of individuals of African American descent undergo lower extremity amputations because of complications from diabetes mellitus (American Diabetes Association 2001). It is estimated that up to 85% of lower extremity amputations can be prevented through programs for preventing and treating foot ulcers, preventing reoccurrence of ulcers, and educating patients about proper foot care (American Diabetes Association 2001). The primary purpose of this article is to describe a church-based educational intervention that was developed to assist individuals of African American descent in the prevention of lower extremity amputations resulting from diabetes. The intervention was designed with the Health Belief Model as the framework. The secondary purpose of this article is to demonstrate the feasibility of using the Roy Adaptation Model as a framework for the same intervention. A comparison of the two frameworks is intended to support the use of the Roy Adaptation Model as a useful guide in the development of community-based nursing interventions. The current nursing literature (based on a search in CINHAL 1995-2003 and MEDLINE 1995-2003) exhibits an abundance of use of health behavior theories not authored by nurses that are used to guide interventions. The comparison of a health promotion model such as the Health Belief Model and a nursing theory is essential to address the relative lack of presence of the use of nursing theories in the realm of health-promoting interventions by nurses.