Culturally-Sensitive Nutrition Education Studied for Pre-Diabetic African American Patients

Withings remote patient monitoring devices will be used by The Strelitz Diabetes Center at Eastern Virginia Medical School (EVMS) in a multi-year ADA-funded study to investigate the efficacy of a culturally-sensitive nutrition program to prevent Type 2 diabetes in African Americans. We interviewed Dr. Henri Parson (EVMS) who is leading the clinical trial, and her co-investigator Ann-Marie Stephens, co-founder of WelFore Health, who is developing the nutritional program and accompanying app, to learn more.

It is well established that the African American population is disproportionately affected by diabetes. The Office of Minority Health at the US Department of Health and Human Services reports that African Americans are:

1. 60% more likely to be diagnosed with diabetes (1)
2. 2.5 times more likely to be hospitalized with long-term diabetes (2) complications.
3. Twice as likely to die from diabetes as Non-Hispanic Whites (3)

The EVMS study will follow 160-180 African American adults who are pre-diabetic or at risk of developing diabetes over the course of 48 weeks. Participants will be brought into the center for quarterly in-person assessments, but they will also be provided Body Pro 2 smart scales and BPM Connect Pro blood pressure monitors for at home use because as Dr. Parson explains, “In a prospective study, we want to capture all the secondary measures we can and have regular remote monitoring.”

The researchers note that there is a gap in the research when it comes to nutrition education. To address this, the nutrition program will emphasize a “food as medicine” approach and will focus on building empathy, trust, and engagement with participants who often have a distrust of clinical trials. Interventions will include meal plans, cooking lessons, daily nudges, and meetings with nutritionists. It will highlight easy-to-follow advice such as making sure non-starchy vegetables make up half the plate and leveraging the power of portion control.

Because Type 2 diabetes tends to follow an intergenerational cycle, WelFore’s Ann-Marie Stephens explains, “We need to help people learn healthier ways to enjoy their cultural heritage foods so they don’t accept the inevitability of diabetes. That to me is the total end game. You’ve got to break that mental mindset.” Heritage foods are such a binding force in the community so preserving culinary traditions is essential to ensure adherence to the program.

When asked for her key takeaway Dr. Parson says, “Healthcare should not be just what the clinical practice guidelines say. It is much much more complex than that. Treat the person as a whole rather than as a symptom. As my mentor Dr. Aaron Vinik often said, “When you understand diabetes, you understand all of health.”

1. CDC 2022. National Diabetes Statistics Report, 2021. Appendix Table 3.
2. National Healthcare Quality and Disparities Reports. Data Query.
3. CDC 2022. National Vital Statistics Report, Vol. 70, No. 7. Table 10.

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