Type 2 diabetes mellitus (T2DM) continues to disproportionately affect African Americans, significantly impacting morbidity and mortality. Research suggests that addressing barriers that stem from socioeconomic circumstances, systemic inequalities, biological factors, and cultural factors may positively influence biometric indicators of health and diabetes control.

The aim of this study was to evaluate a diabetes shared medical appointment (SMA) model program that has been culturally tailored to address the unique social determinants of health barriers faced by an inner city African American population in Norfolk, Virginia.

A pilot study using a within-group pretest–posttest design was conducted. Information was collected from self-report surveys that included the Modified Michigan Diabetes Knowledge Test, the Diabetes Self-Efficacy Scale, and researcher generated surveys before and after a single-session three-hour SMA program.

The program increased perceived diabetes self-care confidence and perceived overall diabetes knowledge levels. Increases in knowledge scores were seen but not statistically significant. Participants reported high levels of satisfaction with the program model.

Findings indicate that this model is an effective and engaging method of improving self-care ability and diabetes disease management knowledge among African Americans. Addressing unique circumstances and barriers experienced by this population may be more effective than usual traditional care approaches.

Ongoing structured patient education, for those with type 2 diabetes, is a core requirement within diabetes health policy. Although type 2 education programmes are becoming established in the UK, a recent review reveals mixed results with little evidence to suggest whether or how such programmes might be directed, to achieve maximal benefit. Black and ethnic minority peoples, and poor and socially disadvantaged groups are especially vulnerable to the effects of the disease. What are the attitudes of these hard-to-reach groups towards diabetes learning?

Eight semi-structured interviews were carried out on participants from different cultural backgrounds. All were from the same primary-care setting, who had type 2 diabetes for more than 12 months. Potential participants were asked to opt in to the research process by invitation letter and in-house poster advertisement. Purposive sampling was undertaken on those who opted in. When recruitment proved difficult, targeted personal approaches were undertaken opportunistically, to increase the opt-in rate, and allow further purposive sampling. During analysis, themes and categories emerged inductively from participants’ dialogue, with no ‘a priori’ categories or themes. The themes were then linked into a map, which ultimately described the whole. The sample size was too small to be representative of the practice population and as such findings were not generalisable to a wider setting.

Diabetes education was highly valued, it was needed so that people felt well and alive; it had to be a respectful experience involving listening and being listened to. It was necessary for the learning to be personal, the desire coming from within. Previous learning related to employment had involved being shown the ropes and was viewed positively. Past diabetes learning had taken place in family settings, in informal meetings and within consultations with health professionals. These were generally preferred to formal classes. The quality of the learning experience was very important to participants. Stress and depression were barriers to learning and diminished capacity to change. The hard to reach are aptly named when trying to recruit for interview studies.