Reaching Out

CINDY SANDERS

Reaching Out | Diabetes, American Diabetes Association, African American Program, Vanessa Jones Briscoe, POWER Over Diabetes, Diabetes Day, Diabetes Focus

Vanessa Jones Briscoe

African American Program Brings Diabetes Education to High-Risk Group

With more than 10 percent of the state's population reporting they have been diagnosed with diabetes and many more classified as being prediabetic, the chronic illness is clearly prevalent across gender, age, race and ethnicity.
 
While no one is immune, an increased risk exists for certain racial and ethnic groups. Compared to non-Hispanic whites, African Americans are 1.6 times more likely to have diabetes. Nationally, 3.7 million, or 14.7 percent, of all African Americans aged 20 years or older have diabetes, according to the American Diabetes Association (ADA). Between the ages of 65 and 74, that figure jumps to 25 percent of the African American population. Complicating the issue, approximately one-third of these diabetics are not even aware they have the disease.
 
Vanessa Jones Briscoe, PhD, NP, CDE, is the Nashville chairperson for the ADA's African American Program (AAP), which encourages people to "Live Empowered." She said such initiatives were created by the ADA to reach specific minority groups with increased disease burden to share information on risk factors, prevention and management of the disease.
 
"The African American Program started in 1996," she noted, adding Nashville was a pilot site. What started out as a single awareness day has grown into a multifaceted outreach initiative. Although progress has certainly been made since efforts began, there is more work to be done, said Jones Briscoe, who is a research assistant professor of medicine for Vanderbilt University's Division of Diabetes, Endocrinology and Metabolism.
 
"I hear people say, 'I have a touch of diabetes;' or 'I don't have the bad kind of diabetes,'" she lamented. Yet, African Americans are 2.6 to 5.6 times more likely to suffer from kidney disease and 2.7 times more likely to suffer from lower-limb amputations. Like every diabetic, the increased risk for heart disease death and stroke occurrence is 2 to 4 times higher than the general population. "They haven't linked it to the diabetes causing all these problems because of a lack of education," Jones Briscoe said.
 
Adding to the problem, she noted, "Within the African American community, traditionally they don't seek medical care because they don't have the resources or access to care." That lack of coordinated care and diabetes education coupled with the increased risk of the disease made it crucial to deliver messages of prevention and management directly to the community.
 
"I've been involved with the program since it was initiated here," said Jones Briscoe. "We're at health fairs. We're in churches. I can see a difference. People are more educated about diabetes, but it's been slow."
 
As with the broader population of diabetics, approximately 90 percent of African Americans with diabetes have been diagnosed with type 2. Jones Briscoe said a major point of emphasis is on the increased risk for developing the disease and simple preventative measures to delay or stop onset.
 
Diabetes Day is the cornerstone of the AAP and was designed to engage a large number of churches each year. When the African American outreach initiative was launched nearly 15 years ago, churches were identified as a novel, but effective, way to reach a large number within the African American community. Additionally, Jones Briscoe noted, many predominantly black churches already have health ministry programs in place.
 
She explained individual churches select their own "Diabetes Day" and allow five-10 minutes for a brief program on diabetes awareness during the regular church service. Educational literature is also passed out to the congregation.
 
Project POWER is another important component of the AAP that is typically church-based and with a Biblical foundation. Jones Briscoe said Project POWER is targeted to those who are already living with diabetes. Modules include:
  • POWER Over Diabetes, which sets the foundation and provides basic information about treatment and management;
  • Fit for the Master's Use, which focuses on the importance of physical activity and maintaining a healthy weight;
  • Taste and See, which demonstrates healthy eating and cooking for the entire family with an emphasis on recognizing appropriate portion sizes and preparing foods in a healthier manner;
  • A Clean Heart, which creates an awareness of the links between diabetes and heart disease and stroke; and
  • Train Up a Child, which brings attention to the increase in type 2 diabetes among African American youth and encourages families to look at ways to live healthier, more active lives.
Other important educational initiatives include the Diabetes Complication Series, a presence at health fairs, diabetes educational workshops, nutritional seminars and Camp Sugar Falls (youth camp). With the continuing increase in the number of Americans with diabetes, Jones Briscoe said these and other ADA programs are crucial. She also called on healthcare providers to rely on the ADA as a key partner to help with diabetes education. "When you are in a clinical setting telling someone, 'you have diabetes,' they are hearing it … but they're not really hearing it," she said, noting so many patients just feel overwhelmed at the diagnosis.
 
"To me, education is key for the person with diabetes. Without sound and credible information about the disease and how to live with it, the person is at increased risk for developing the devastating complications of the disease that include blindness, amputations, kidney disease, stroke and heart disease," concluded Jones Briscoe. "The ADA has a Web site and publications that help the patient with diabetes learn about the disease and how to live with the disease. I think this is a valuable resource that clinicians can offer their patients. These resources aid in the continuing education that must go on for the person with the disease and can also assist to reinforce information that the clinician gives to the patient. The Web site is www.diabetes.org, and one of the ADA publications that I often recommend to patients is the Diabetes Forecast."