{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T05:47:24Z","timestamp":1785822444279,"version":"3.56.0"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>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\u2019s implementation outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>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\u202fmonths, and qualitative interviews explored participant experiences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      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\u2019 mean age was 57; 81% were female, and 75% had type 2 diabetes. Participants reported improvements in overall health (12.1%,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.02), patient health engagement (82.8%,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.01), and diabetes empowerment (19.7%,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.01). Self-care behaviors, such as diet, blood glucose monitoring, and foot care, improved significantly. Retention was 100%, with average attendance of 86% and high satisfaction (mean 4.2\/5). Qualitative findings highlighted empowerment, accountability, and trust, fostered by culturally affirming facilitation and group support. Participants recommended longer sessions and hybrid formats.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1806362","type":"journal-article","created":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T05:38:14Z","timestamp":1785821894000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Culturally adapting an evidence-based diabetes self-management education program for black adults: a pilot mixed methods implementation study"],"prefix":"10.3389","volume":"14","author":[{"given":"Olubukola","family":"Tikare","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacy, University of Michigan College of Pharmacy","place":["Ann Arbor, MI, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Omuya","sequence":"additional","affiliation":[{"name":"Division of Health Services Administration, University of Alabama","place":["Birmingham, AL, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meng-Jung","family":"Wen","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences, University of Rochester","place":["NY, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tina","family":"Kansariwala","sequence":"additional","affiliation":[{"name":"Division of Social and Administrative Sciences, University of Wisconsin-Madison","place":["Madison, WI, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annika","family":"Pickard","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Systems, Outcomes, and Policy, University of Illinois","place":["Chicago, IL, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janiya","family":"Pouncy","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, University of Michigan College 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