Culturally adapting an evidence-based diabetes self-management education program for black adults: a pilot mixed methods implementation study.

Introduction: Black adults in the United States disproportionately experience type 2 diabetes and related complications, yet participation in diabetes self-management education (DSME) is low. Culturally adapted approaches are needed to improve engagement and outcomes. This pilot study evaluated the implementation of a co-designed culturally adapted DSME program for Black adults using the RE-AIM framework and Proctor's implementation outcomes. Design: This pilot mixed-methods implementation study evaluated a culturally adapted 6-week group based DSME program delivered in community settings. Thirty-two Black adults with diabetes or prediabetes were enrolled. Implementation outcomes included attendance, retention, and satisfaction. Participant-reported outcomes were assessed at baseline and 6 months, and qualitative interviews explored participant experiences. Results: Retention was 100%, with high attendance (86%) and strong satisfaction, indicating high feasibility and acceptability. Participants reported improvements in engagement, empowerment, and self-care behaviors. Qualitative findings highlighted the role of culturally affirming facilitation, trust and group support in promoting participation in DSME. Participants' mean age was 57; 81% were female, and 75% had type 2 diabetes. Participants reported improvements in overall health (12.1%, Conclusion: The program was feasible and acceptable, and was associated with improvements in self-reported self-care and empowerment among Black adults. Findings support further testing in larger trials to assess long-term effectiveness and implementation. Given the single-arm design, findings should be interpreted as exploratory.