Using focus groups of older African Americans and Latinos with diabetes to modify a self-care empowerment intervention

Objective: To make cultural and age-specific modifications to a self-care empowerment intervention. Design: Focus groups with self-administered surveys. Setting: Two public health diabetes and geriatrics clinic and two senior centers in and around South Los Angeles. Participants: African Americans and Latinos aged >= 55 years with diabetes (N=79), and two groups of health educators (N=16). Main Outcome Measures: After describing the proposed intervention, the focus group facilitators asked participants: 1) whether the community of interest would be interested in the proposed empowerment intervention; 2) why or why not; and 3) how the intervention could be modified to better address the concerns of the study community of interest. All groups were audiotaped, transcribed, and (when appropriate) translated into English. Three independent investigators read all transcripts and completed standardized coding forms for each transcript. In addition, at the end of each focus group, all participants completed a self-administered written survey asking them to rate aspects of the proposed intervention. Results: Older African Americans and Latinos endorsed the intervention but desired an expanded dietary educational component and identified disability as an important missing content area. Participants rejected the use of an audio learning tool and did not believe that matching group-facilitator sociodemographic characteristics was important as long as facilitators demonstrated cultural competency. Conclusions: These findings illustrate a model of participatory research in which researchers and community members work together to develop an empowerment intervention that will meet community needs and will have greater cultural appropriateness. Modifying the intervention in accordance with these findings should enhance the relevance and impact of the self-care intervention.