Faith-Based Adult Learning Initiatives for Diabetes Education in the African American Community.

African Americans' Faith and Religion Historically, religion and spirituality have been major influences in the social, cultural, and political lives of African Americans. Spirituality is deeply embedded into their rich cultural heritage, and it is intertwined into all aspects of their lives, including beliefs about health and illness. For African Americans, health and illness are a dynamic entity, governed by body, mind, and soul. Therefore, it is imperative that any adult learning initiatives include the importance of cultural dynamics. Religion provides individuals with a shared world view that they come to experience as persuasive and meaningful. Given its historical and ongoing role within the African American community, the church offers an ideal setting for health promotion and prevention activities as well as religious educational opportunities. Such health activities are warranted because: (a) African Americans have lower life expectancies, (b) they are less likely to have health insurance, and (c) they make fewer primary care office visits when compared to their white counterparts (Harris, 2001). The African American church can be viewed as a positive influence in the African American community. It provides spiritual guidance and direction as well as helps meet the day-to-day needs of congregants through a broad range and use of social services and commitment to the community. Diabetes, Incidence, and Prevalence Diabetes is a disease in which the body does not produce or properly use insulin. Insulin is a hormone that converts sugar, starches, and other foods into energy needed for daily life. There are many theories that attempt to elucidate the cause of diabetes, including genetics, and environmental factors, such as obesity, lack of exercise, and poor nutritional habits. Regardless of the cause, diabetes is reaching epidemic proportions, both nationally and internationally' It is the sixth leading cause of death for Americans in the United States. It is estimated that 57 million Americans have pre-diabetes, a condition that leads to overt diabetes if not properly managed (American Diabetes Association, 2008). More than 2.2 million African Americans have diabetes; 1.5 million have been diagnosed and 730,000 have not yet been diagnosed. African Americans are disproportionately affected with diabetes, and it has been estimated that there are four times as many African Americans diagnosed with diabetes today as there were in 1968. Approximately 90% to 95% of all diagnosed cases of diabetes are considered type 2 diabetes (formerly called adult-onset diabetes). This condition occurs when the body does not make enough insulin or cannot effectively use the insulin it makes. This form of diabetes usually develops in adults over the age of 40, but is becoming more prevalent in younger age groups, including children and adolescents. Common symptoms of type 2 diabetes are: (a) feeling tired or ill, (b) unusual thirst, (c) frequent urination, especially at night, (d) unexplained weight loss, (e) blurred vision, (f) frequent infections, and (g) slow-healing wounds. In very rare cases, there may be no symptoms at all. In adults, there are several other risk factors associated with the development of type 2 diabetes. Having a family history of type 2 diabetes puts one at greater risk for the disease. Increased body weight also raises the risk. With age, the body becomes more resistant to the actions of insulin; therefore, as one ages, the incidence of type 2 diabetes is likely to increase. Lifestyle factors, such as lower rates of physical activity and poor dietary and nutritional practices, also increase the risk of developing type 2 diabetes. Type 2 Diabetes in African Americans Despite the overall health of the United States population having improved over the past two decades, diabetes has reached epidemic proportions among African Americans and contributes significantly to higher morbidity and mortality rates in this population. …