Resilience Improves Diabetes Self-Management, According to Preliminary Study Results

April 28, 2008

AUSTIN, Texas — Resilience expert Dr. Mary Steinhardt has completed the first stage of a diabetes study, the results of which show that coaching classes and resilience-building can help African American adults with type 2 diabetes more successfully self-manage the disease.

Given the high prevalence of obesity, type 2 diabetes and cardiovascular disease (CVD) in the African American population, Steinhardt is particularly interested in seeing if self-management can reduce the incidence and severity of these health problems. A sample of 16 African Americans in East Austin was recruited to participate in Steinhardt's Diabetes Coaching Program (DCP), and 12 subjects completed this first training program.

"Preliminary results do indicate improvement in the subjects—diabetes self-management, body mass index, total cholesterol, LDL cholesterol, blood pressure, resilience, perceived stress and fasting blood glucose level," says Steinhardt, a professor in the College of Education's Department of Kinesiology and Health Education at The University of Texas at Austin.

"Type 2 diabetes is almost always preceded by obesity, and recent statistics indicate that around 45 percent of African Americans are obese and 76 percent are overweight. In addition, type 2 diabetes results in a two to four times higher rate of CVD, which is the leading cause of death among African Americans with diabetes. The normal progression of obesity, type 2 diabetes and CVD is the biggest health threat facing the U.S. right now. The unremitting accumulation of damage is largely preventable, and that's what our training program is about."

Steinhardt points out that people with a chronic disease such as type 2 diabetes typically experience a greater degree of stress, worry and depression than non-diseased individuals and that this stress often leads to unhealthy lifestyle choices. The cycle continues, as unhealthy lifestyle choices facilitate obesity, type 2 diabetes and CVD.

"The positive correlation between stress and unhealthy lifestyle choices is well-established," says Steinhardt. "If coaching and training can help individuals develop resilience and good coping strategies, then stress, anxiety and depression should decrease, and positive perceptions of physical health and beneficial habits should increase.

"Feelings of self-empowerment and self-efficacy should help individuals with type 2 diabetes regularly make healthy decisions about nutrition, physical activity, medications and blood glucose monitoring."

The DCP included four weekly two-hour classes that were held at Olivet Baptist Church in East Austin. The sessions were tailored to meet the specific cultural needs, goals, resources and lifestyle of the African American participants. One hour of each class was devoted to Steinhardt's "Transforming Lives Through Resilience Education Program" and one hour was devoted to learning about healthy nutrition choices. Eight bi-weekly hour-and-a-half-long support group meetings followed the program.

The pilot study documented the feasibility and potential effectiveness of the DCP to foster self-management and resilience in African Americans with type 2 diabetes, and participants have offered valuable feedback that can be incorporated in future studies. Subjects from the inaugural study also are mentors to participants in the second study that is now in progress.

"The thrust of resilience intervention is to help someone be able to take responsibility for his or her own life choices," says Steinhardt, "and to become more aware of the consequences of decisions made on a daily basis. Health complications from type 2 diabetes constitute a huge burden on the African American community. If we can teach individuals with the disease how to cope more effectively, eat healthier, engage in physical activity and stay motivated, we're easing some of that burden."

University of Texas at Austin nursing professor and diabetes expert Dr. Sharon Brown, as well as doctoral candidates Sarah Mount, Jong-Ho Kim and Madonna Mamerow, are working with Steinhardt on the diabetes study.

To raise funds for her research, Steinhardt has made diabetes wristbands and inspirational cards available for purchase online. All proceeds from the sale of these items will go to fund her diabetes research.

Steinhardt is a Fellow in the Lee Hage Jamail Regents Chair in Education and was the first recipient of the Dean's Distinguished Teaching Award in the College of Education. The Texas Exes honored Steinhardt with the Texas Excellence Teaching Award. She was selected for The University of Texas at Austin's Academy of Distinguished Teachers and in 2007 was given the Robert Murff Excellence Award for her outstanding support of student career services.

She has worked with companies like 3M, Motorola, Dell, Applied Materials and Home Depot to help them develop and implement programs to enhance individual and organizational resilience, as well as with the Texas Department of Aging and Disability Services. Steinhardt has received more than $2 million in grants and gifts to support her work and has published more than 40 manuscripts.

Read more about Steinhardt's resilience research and access training materials.

For more information, contact: Kay Randall, College of Education, 512 471 6033.