Reducing disparities in diabetes among African-American and Latino residents of Detroit: the essential role of community planning focus groups.

Diabetes is prevalent among African-American and Latino Detroit residents, with profound consequences to individuals, families, and communities. The REACH Detroit Partnership engaged eastside and southwest Detroit families in focus groups organized by community, age, gender, and language, to plan community-based participatory interventions to reduce the prevalence and impact of diabetes and its risk factors. Community residents participated in planning, implementing, and analyzing data from the focus groups and subsequent planning meetings. Major themes included: 1) diabetes is widespread and risk begins in childhood, with severe consequences for African Americans and Latinos; 2) denial and inadequate health care contribute to lack of public awareness about pre-symptomatic diabetes; 3) diabetes risks include heredity, high sugar, fat and alcohol intake, overweight, lack of exercise, and stress; and 4) cultural traditions, lack of motivation, and lack of affordable, accessible stores, restaurants, and recreation facilities and programs, are barriers to adopting preventive lifestyles. Participants identified community assets and made recommendations that resulted in REACH Detroit's multi-level intervention design and programs. They included development of: 1) family-oriented interventions to support lifestyle change at all ages; 2) culturally relevant community and health provider education and materials; 3) social support group activities promoting diabetes self-management, exercise, and healthy eating; and 4) community resource development and advocacy.