Authors: Trudy Gaillard, Joan A. Vaccaro, Stephanie Caceres, Fatma G. Huffman.
Introduction: Cultural humility is a patient-centered approach that involves reflective listening and awareness of personal cultural biases. The Health Belief Model was integrated with cultural humility to deliver a patient-centered diabetes and exercise intervention.
Purpose: The purpose of this manuscript is to discuss how cultural humility was implemented into a diet and exercise intervention aimed at assisting low-income Hispanic older adults with type 2 diabetes formulate, reach,and maintain diet and exercise goals.
Methods: Thirty-nine older Hispanics with type 2 diabetes (78.5±6.6 years) participated in the study at three congregate meal sites serving primarily Spanish speaking older adults. We modified evidence-based diabetes education materials and translated/back-translated into Spanish. We piloted these materials and made adjustment to the intervention based on process evaluations from participants and feedback given by the staff.
Results: We became aware of our own ethnocentrism regarding diet and exercise and made modifications of the intervention based on cultural humility: listening to participants through process evaluations. We actualized our cultural humility by re-teaching using client-centered strategies. We made modification in the program based on what participants needed to become successful. We discovered that older Hispanic adults wanted more individualized instructions based on their specific diet and exercise preferences as compared to group instruction.
Summary and Conclusions: To teach, reach, and retain participants, we recommend that diabetes educators incorporate cultural humility when planning community-based lifestyle intervention programs targeting older Hispanic adults. Most importantly, team meetings to review clients’ responses became important in updating and evaluating the program.
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