FHI 360 received a grant from the U.S. Department of Health and Human Services’ Office of Minority Health to test and implement a novel family-centered approach for control, management and prevention of type 2 diabetes among Black families in Montgomery County, Maryland. The Black Family-Focused Diabetes Control, Management and Prevention Program is testing whether a family-centered approach — in which persons with diabetes (PWDs) and up to two family members work with a community health worker and receive evidence-based diabetes-focused education — leads to more healthful eating, increased physical activity, shared lifestyle planning, increased social support and better health outcomes (such as medication adherence and reduced/stable A1C).

Black families bear a disproportionate burden of diabetes nationally and by state, and Black Marylanders’ rates of diabetes-related hospitalizations and death are twice those of white Marylanders. Attention to family and cultural factors for diabetes self-management is critical for Black PWDs because of the importance of family in Black culture; diabetes’ multigenerational “legacy”; and the value Black families place on collectivism, interdependence and cooperation (Routh et al., 2019). Most current evidence-based diabetes self-management education and support (DSMES) programs do not address the interpersonal, family and cultural factors critical for lasting success.

This intervention draws on evidence-based DSMES programs, as well as the National Diabetes Prevention Program (National DPP) lifestyle change program for adult family members with prediabetes or at risk for type 2 diabetes.

The goals of the demonstration project include:

• Identifying family-centered structural, instrumental, functional, cultural, relationship, communication and social needs factors required to promote type 2 diabetes control and prevention.
• Creating supportive environments with a PWD and other family members at risk for diabetes.
• Reducing diabetes disparities in the project area.
• Developing an effective, sustainable and scalable program.

The project is led by FHI 360, in partnership with the University of Maryland’s Center for Health Literacy, Howard University and McFarland & Associates.