Telephone helps reduce diabetes health disparities and improves health outcomes

In this high-tech world of electronic communications, the older, reliable form of communication via the telephone has proven effective in reaching out to older African-American women with diabetes.

From research presented at ISHIB2005, elderly African-American women with diabetes receiving direct phone communication had improved problem-solving skills, psychosocial adjustment, and increased levels of exercise compared to those in the study’s control group.

Age, ethnicity, lower socioeconomic status and being female increase the likelihood of developing diabetes and its complications. Older African-American women are among the group with the highest rates of diabetes in this country. The Centers for Disease and Control reports that 33% of African-American women ages 60-74 years have diabetes, compared to 16% of White women of the same age group. For middle-aged women, type 2 diabetes is more than twice as common among non-Whites as it is among Whites. Among women aged 50-59 years, the prevalence is 23% for Blacks, 24% for Mexican Americans, and 9.7% for Whites.

The study presented at ISHIB2005 was designed to determine ways to reduce these diabetes health disparities and to improve health outcomes. Knowing that many issues hinder efforts to provide appropriate care to older African-American women, researcher Emelia Amoako, PhD designed a study that shows that the older form of communication - the telephone - can be used to deliver a convenient, low-cost and individualized intervention appropriate for the African-American culture.

To conduct the study, Amoako selected 68 participants (mean age of 61 years) who had been diagnosed with diabetes within two years. Half the participants were randomly assigned to the experimental group and the others to a control group. Through phone communication, those in the experimental group received interventions including diabetes information; patient-provider communication; problem-solving techniques; and cognitive reframing. These participants received individually tailored information on the cause, diagnosis and management of diabetes, as well as a list of available diabetes-related resources in their county of residence. Participants also received printed information on diabetes self-management.

“This study has shown that teaching problem-solving skills and assisting older African-American women to apply these skills enabled them to overcome barriers to physical activity/exercise and the maintenance of newly established behaviors that assist with diabetes self-care,” stated Amoako, who is an assistant professor at the School of Nursing at the University of North Carolina at Greensboro. “We demonstrated that the telephone is useful in helping older African-American women cope with diabetes.”

This research was funded through the John A. Hartford Foundation and its Building Academic Geriatric Nursing Capacity Program. Amoako is a scholar of the foundation, dedicated to improving the health outcomes of older individuals through research and education. Amoako’s colleagues, Anne H. Skelly PhD and Sandy Funk PhD of UNC-Chapel Hill School of Nursing, also participated in the study design and research processes.