Type 2 diabetes is emerging as a serious health problem, especially in high risk minority communities. The highest rates of type 2 diabetes are found among the African American, American Indian/Alaskan Native, and Latino populations (Diamant, 2007). Compared to non Latino white adults with diabetes, African American and Latino adults with diabetes are also more likely to have poorer control of their blood glucose levels and higher rates of complications (Mainous, King, Garr, & Pearson, 2004; Gonsalves, Gessey, Mainous, & Tilley, 2007; Marshall, 2005). More than 1.8 million California adults, or about 7% of the population 18 years and older, have been diagnosed with diabetes (Diamant, 2007). Individuals at high risk can benefit from efforts to prevent or delay the onset of type 2 diabetes with moderate physical activity, a low-fat diet, and modest weight loss (Williamson, Vinicor, & Bowman, 2004).
Low-income African American and Latinos face multiple and interrelated barriers to diabetes prevention and control, e.g., poverty, lack of access to health care, limited literacy, and cultural values and beliefs that are not considered adequately by the health care system (Rhee et al., 2005; Kieffer et al., 2004; Carlson, Neal, Magwood, Jenkins, King, & Hossler, 2006). Conventional diabetes education programs, including standard weight loss treatment, have limited impact on some African American adults (Wing & Anglin, 1996; Liburd, Anderson, Edgar, & Jack, 1999). Lack of cultural sensitivity and unrealistic weight loss goals of conventional programs may explain the higher dropout rates observed among black compared to white adults. Culturally sensitive diabetes education and support programs can improve outcomes, even in underserved, low income populations (Anderson Loftin, Barnett, Bunn, Sullivan, Hussey, & Tavakoli, 2005; D'Eramo Melkus et al., 2004; Williams, Auslander, de Groot, Robinson, Houston, & Haire Joshu, 2006).