Date of Award


Document Type


Degree Name

Doctor of Philosophy (PhD)

Legacy Department


Committee Chair/Advisor

Bodine, Ashby B

Committee Member

Cason , Katherine L

Committee Member

Haley-Zitlin , Vivian J

Committee Member

Bridges , William


ABSTRACT The purpose of this pilot study was to determine the feasibility of a paraprofessional-led multifaceted six-week nutrition education program and to explore the diabetes-related health and behavioral outcomes in adult African Americans of lower income and lower educational levels who have been diagnosed with type 2 diabetes. The Quasi-experimental design consisted of a control group and an experimental group with pre and post-test administration. The groups were pre-assigned by their participation in the Racial and Ethnic Approaches to Community Health (REACH) 2010 program of Charleston County, South Carolina. The nutrition education intervention consisted of a total of six lessons conducted by a Clemson Extension paraprofessional. The From MyPyramid to the Plate curriculum consisted of three lessons developed by the researcher and three lessons and recipes from the Dining with Diabetes program developed by the Extension Service at West Virginia University. The recipes were used for the cooking sessions. Both groups were administered pre-test surveys using the following instruments: 1) Diabetes Care Profile (DCP) (demographic questions) - Michigan Diabetes Research and Training Center Demographics, Health Status, Education and Advice Received, Understanding, and Support; 2) Lifestyle Questionnaire (history section) - American Diabetes Association and American Dietetic Association. Both groups were also administered three pre-test and post-test surveys consisting of: 1) Knowledge, Attitude and Practice Survey (KAP) - a combination of the From MyPyramid to the Plate and Dining with Diabetes surveys; 2) Diabetes Empowerment Scale - Short Form (DES-SF) survey and 3) Diabetes Attitude Scale-3 (DAS-3) survey - both from the Michigan Diabetes Research and Training Center. To compare percentages of pre-test Diabetes Care Profile demographics and Lifestyle history survey questions between the experimental and control groups, a Chi-square test was used. To compare mean pre and post-test scores of the Diabetes Empowerment Scale-SF, the Diabetes Attitude Scale-3, and KAP survey questionnaires; and to compare experimental and control groups, an Analysis of Variance (ANOVA) was used to compare all four groups, with Fisher's Least Significant Difference (LSD) to compare the specific group means to each other. Results from this study suggest that the paraprofessional-led model of nutrition education is an effective way to improve important health measurements by increasing the participants' sense of self empowerment in the self-management of diabetes. Improvement in these health measurements may lead to a decrease in related health complications which in turn will lead to a decrease in diabetes related healthcare costs to the individual and the community. Additionally, further development and validation of educational materials that can be taught through the paraprofessional model would prove useful in reaching the more rural areas with limited resources and limited access to medical care. This model of teaching has been proven effective in relating to the individual on a peer to peer basis while providing sound nutrition education to improve health outcomes.

Included in

Nutrition Commons



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