Hawkins Jaclynn M, Ewen Alana M, Funnell Martha, Nwankwo Robin, Piatt Gretchen
School of Social Work, University of Michigan, Ann Arbor, MI, USA.
Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD, USA.
Contemp Clin Trials Commun. 2025 Apr 21;45:101487. doi: 10.1016/j.conctc.2025.101487. eCollection 2025 Jun.
Black men experience disproportionately high rates of type 2 diabetes (T2D) and its complications, yet remain underrepresented in diabetes intervention research. Culturally tailored, community-based interventions that prioritize trust and address structural barriers are essential for improving recruitment and retention in this population. This article provides insights from the Michigan Men's Diabetes (MenD I and II) Projects, a peer-led diabetes self-management intervention tailored to Black men with T2D. MenD I and MenD II used Diabetes Self-Management Education (DSME) and Peer-Led Diabetes Self-Management Support (PLDSMS) sessions delivered virtually to meet participants' needs. Recruitment efforts engaged trusted community organizations, healthcare providers, and targeted outreach. Retention strategies emphasized trust-building, flexible scheduling, and culturally resonant support mechanisms, such as fostering a sense of community, providing personalized check-ins, and incorporating time for informal interactions and relationship-building. Data collected from pre- and post-intervention assessments and participant feedback illustrate the effectiveness of these approaches in addressing barriers and sustaining engagement. Despite challenges like medical mistrust, systemic inequities, and competing responsibilities, the MenD studies demonstrate that well-designed peer-led interventions can effectively engage Black men. These findings highlight the importance of culturally tailored adaptations and strong community partnerships in overcoming barriers to participation. Insights from MenD I and II offer valuable guidance for reducing health disparities and improving diabetes outcomes for Black men.
黑人男性患2型糖尿病(T2D)及其并发症的比例极高,但在糖尿病干预研究中的代表性仍然不足。以文化为导向、基于社区的干预措施,将信任作为优先事项并解决结构性障碍,对于提高该人群的招募率和留存率至关重要。本文提供了密歇根男性糖尿病项目(MenD I和II)的见解,这是一项由同伴主导的糖尿病自我管理干预措施,专门针对患有T2D的黑人男性。MenD I和MenD II使用糖尿病自我管理教育(DSME)和同伴主导的糖尿病自我管理支持(PLDSMS)课程,以虚拟方式授课以满足参与者的需求。招募工作涉及受信任的社区组织、医疗保健提供者和有针对性的外展活动。留存策略强调建立信任、灵活安排时间以及具有文化共鸣的支持机制,例如营造社区感、提供个性化的跟进服务,以及留出时间进行非正式互动和建立关系。从干预前和干预后的评估以及参与者反馈中收集的数据说明了这些方法在解决障碍和维持参与度方面的有效性。尽管存在医疗不信任、系统性不平等和相互竞争的责任等挑战,但MenD研究表明,精心设计的同伴主导干预措施可以有效地让黑人男性参与进来。这些发现凸显了文化定制调整和强大的社区伙伴关系在克服参与障碍方面的重要性。MenD I和II的见解为减少健康差距和改善黑人男性的糖尿病治疗效果提供了宝贵的指导。