A pilot mixed methods randomized control trial investigating the feasibility and acceptability of a culturally tailored intervention focused on beliefs, mistrust and race-congruent peer support for Black adults with diabetes

Meng-Jung Wen ¹ Martha Maurer ² Annika Pickard ¹ Mackenzie Hansen ¹ Olayinka Shiyanbola ^1*

• ¹ University of Wisconsin-Madison, Madison, United States
• ² Sonderegger Research Center for Improved Medication Outcomes, School of Pharmacy, University of Wisconsin-Madison, Madison, Wisconsin, United States

There is a lack of , yet few diabetes self-management programs that target address their unique Black adults' health beliefs, provider mistrust and sociocultural barriers to taking diabetes medications. A This 6-month pilot randomized feasibility trial was conducted to compared a culturally tailored diabetes self-management program, which incorporated incorporating beliefs about diabetes, mistrust, and race-congruent peer support with to a standard diabetes program. An embedded mixed methods design was used to examined the feasibility of implementing the pilot trial, including recruitment, retention, intervention adherence and assessed participant acceptability of the intervention. Throughout the trial, the capability for recruiting and retaining participants, was evaluated as well as intervention adherence and acceptability. Data were collected through participant self-reported questionnaires, field notes, semi-structured interviews, and focus groups. Qualitative content analysis inductively explored participants' feedback on the program, participation barriers and potential strategies to overcome the challenges. Mixed methods integration was implemented using a side-by-side joint display to compare, synthesize and interconnect the quantitative and qualitative results across all feasibility domains. Thirteen participants (93%) completed the trial, demonstrating high adherence and retention. Community outreach and implementing a prerequisite orientation using motivational interviewing approaches were found feasible and appropriate to recruit potential participants. Participants expressed high satisfaction and acceptabilitywere highly satisfied with the program, and demonstrated high intervention adherence and retention rate. Qualitative findings further explained the quantitative results, highlighting that the importance of peer support, cultural relevant content and a safe space for sharing experiences were key elements for high Formatted: Superscript acceptability. Barriers to participation were identified including schedule conflicts and difficulties in engagement. Future large-scale effectiveness trials should consider combining multimedia into recruitment methods, tailoring the program to address medication-taking goals, and addressingexploring social and environmental barriers to sustain healthy support sustained lifestyle changes.