Black Family and Community Health Worker Dynamics in a Family-Centric Diabetes Prevention and self-Management Education and Support Intervention

PURPOSE: The purpose of the study was to assess a culturally tailored, family-focused diabetes self-management education and support intervention with community health worker (CHW) support among Black families with prediabetes and diabetes. METHODS: The study enrolled 70 Black family members and assigned them CHWs for a 20-week diabetes prevention and self-management education and support intervention. Family members and CHWs were interviewed, and thematic analysis identified 4 themes associated with family-CHW dynamics that affected program outcomes: (1) family and CHW communication, (2) health literacy support, (3) technology support, and (4) program adherence support. The communication dynamics were bidirectional, and the health literacy, program adherence, and technology support flowed from CHWs to families. RESULTS: Participants appreciated that their CHWs were empathetic, relatable, adaptable, and good communicators, and both families and CHWs spoke of strong emotional and task-based bonds. CHWs' positive impact on adherence was confirmed. Data on health literacy and technology support activities identify families' additional needs to be successful in these programs. CONCLUSIONS: The study results on family-CHW dynamics add to the literature on family-based diabetes prevention and self-management education and support programs and the limited literature on how participants and CHWs interact, communicate, and share information during lengthy chronic disease programs. Expanding the public health impact of diabetes programs for Black adults may come from innovations in family-based programs supported by positive CHW interactions.