Impact of spiritual beliefs and faith-based interventions on diabetes management

Table 2 Studies on the impact of faith-based interventions on diabetes management

Ref.	Topic	Study objective	Sample	Intervention	Result
Duru et al[47]	Sisters in Motion: A randomized controlled trial of a faith-based physical activity intervention	To evaluate a faith-based intervention (“Sisters in Motion”) intended to increase walking among older, sedentary African American women	Sixty-two African American women > 60 yr	Multi-component curriculum including scripture readings, prayer, goal-setting, a community resource guide, and walking competitions. Both intervention and control participants participated in physical activity sessions	At 6 mo, intervention participants had increased their weekly steps by 9883 on average, compared to an increase of 2426 for controls (P = 0.016); SBP decreased on average by 12.5 mmHg among intervention participants and only 1.5 mmHg among controls (P = 0.007)
Fitzgibbonet al[64]	Results of a faith-based weight loss intervention for black women	The goals of the study were to estimate the effects of a 12-wk culturally tailored, faith-based weight loss intervention on weight loss, dietary fat consumption and physical activity	Fifty-nine overweight/obese black women were randomized to one of the two interventions	"Faith on the Move," intervention	Although the results were not statistically significant, the effect size suggests that the addition of the faith component improved results.
Sattinet al[65]	Community trial of a faith-based lifestyle intervention to prevent diabetes among African-Americans	To reduce weight and fasting plasma glucoseand increase physical activityfrom baseline to week-12 and to month-12 among overweight parishioners through a faith-based adaptation of the diabetes prevention program called “FBAS”	604 African Americans, aged 20 to 64 years single-blinded, cluster-randomized, community trial	FBAS is an adapted faith-based diabetes prevention program	FBASparticipants had a significant difference in adjusted weight loss compared with those in HE (2.62 kg vs 0.50 kg, P = 0.001) at 12-wk and (2.39 kg vs − 0.465 kg, P = 0.005) at 12-mo and were more likely (13%) than HE participants (3%) to achieve a 7% weight loss (P < 0.001) at 12-wk and a 7% weight loss (19% vs 8%, P < 0.001) at 12-mo.
Gutierrez et al[66]	Health, community, and spirituality: Evaluation of a multicultural faith-based diabetes prevention program	To evaluate FFF, a faith-based diabetes prevention program for black and Latino congregants at churches in low-income New York City neighborhoods	Participants (n = 183)	FFF, a faith-based diabetes prevention program. FFF is a 12-wk, bilingual program developed by the Bronx Health REACH Coalition, FFF includes nutrition education and fitness activities while incorporating Bible-based teachings that encourage healthy lifestyles	Participants reported statistically significant improvements in knowledge and healthy behaviors from baseline. Increased numbers of participants reported exercising in the past 30 d, eating fruit daily, being able to judge portion sizes, and reading food labels
Frank et al[67]	A faith-based screening/education program for diabetes, CVD, and stroke in rural African Americans	To investigate the effectiveness of a faith-based screening/education program for reducing diabetes, cardiovascular diseases, and stroke in rural African Americans	120 parishioners from African American churches	The program included education about the prevention of diabetes and cardiovascular diseases	Positive feedback was recorded by both pastors and participants
Rhodes et al[68]	Cost-effectiveness of a faith-based lifestyle intervention for diabetes prevention among African Americans: A within-trial analysis	To assess costs and cost-effectiveness of implementing FBAS, a church-based 18-session lifestyle education intervention for African Americans	604 overweight participants in 20 churches	FBAS, a church-based 18-session lifestyle education intervention	Per-person intervention cost of FBAS was $50.39 more than HE ($442.22 vs $391.83 per person), and adjusted differences in weight change (1.9 kg [95%CI: 1.0-2.8]) and waist circumference (2.4 cm [95%CI: 1.3-3.4]) were both significant. For a modest increase in cost, FBAS led to greater weight and waist reductions among African Americans in a church setting
McElfish et al[69]	Design of comparative effectiveness of a randomized controlled trial testing a WORD DPP vs a PILI DPP for Marshallese in the United States	To investigate the comparative effectiveness trial testing 2 DPP interventions designed to reduce participant's weight, lower HbA1c, encourage healthy eating and increase physical activity	384 Marshallese participants from 32 churches located in Arkansas, Kansas, Missouri, and Oklahoma	WORD DPP focuses on connecting faith and health to attain a healthy weight, eat healthily, and be more physically active. In contrast, PILI DPP is a family and community-focused DPP curriculum specifically adapted for implementation in Pacific Islander communities	Ongoing
Goode[70]	The effect of a diabetes self-management program for African Americans in a faith-based setting (pilot study)	To test a 6-wk faith-based diabetes self-management program for African American adults diagnosed with diabetes	32 African Americans 18 yr or older participate in the study	Diabetes self-management education intervention	There were significant improvements among participants in diabetes knowledge, self-efficacy, diabetes symptom management, and improvements in diabetes self-care activities (diet, exercise, and foot care)

CVD: Cardiovascular disease; DPP: Diabetes prevention program; FBAS: Fit body and soul; FFF: Fine, fit, and fabulous; PILI DPP: Pacific culturally adapted diabetes prevention program; WORD DPP: Faith-based diabetes prevention program.