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Medically reviewed by Dr. Shani Saks, D.O. on Sept. 7, 2023

This study determined that a novel culturally tailored program for the management of diabetes fulfilled the needs of African American patients and stakeholders. The study also identified several acceptance and logistical organizational barriers that need to be addressed.

The engagement of stakeholders in the implementation of diabetes self-management programs for African American patients can help improve health outcomes and address barriers associated with adherence to existing programs. In this study, published in the International Journal of Environmental Research and Public Health, the authors conducted semi-structured interviews with organizational leaders and healthcare professionals who provide health services and education to the African American community to evaluate stakeholder perspectives on the new program. The study identified how a new culturally tailored program for managing diabetes fulfilled the needs of African American patients and also delineated the perceived barriers and challenges of the program.  

Study Characteristics

The authors conducted a total of 13 interviews with six organizational leaders and seven healthcare professionals (dieticians, chief medical officers, pharmacists, and diabetes educators) who have worked with the African American community.

Perspectives of Stakeholders on Peers EXCEL Implementation

Regarding the implementation of the program, known as the Peers’ Experience in Communicating and Engaging in Healthy Living (Peers EXCEL), the authors identified five themes based on the stakeholders’ responses. These themes included the fulfillment of the needs of the stakeholders; empowerment of peers and fostering relationships; identification of logistical organization barriers that may hinder the implementation of the program; challenges in the acceptance of the program by the patients; and the development of a trusting and supportive environment to counter distrust among stakeholders. 

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To overcome the perceived barriers and challenges, the community stakeholders suggested some possible strategies. These included engaging with African Americans and healthcare practitioners serving this community so as to improve awareness of the Peers EXCEL program and facilitate its implementation.  

Fostering Peer Support for Health Conversations

Peer support has become essential for open health discussions. Stakeholders recognize Peers EXCEL’s benefits for building trust and security for participants. Stakeholders believe that actively listening and learning from their peers can help patients connect with each other’s experiences and improve healthcare specialists’ views. Peer assistance has helped patients convey their concerns to compassionate people who know how to solve their problems.

This novel culturally tailored program for the management of diabetes fulfills the needs of African American patients as well as the stakeholders; however, there are several acceptance and logistical organizational barriers that should be addressed.

Enhancing Support Through Peer Connections

Healthcare specialists recommend peer support for participant interactions and motivation. Peer dialogues can combine collective dietary experiences into program content, offering options and perspectives. Healthy Living with Diabetes (HLWD) organizations recognize Peers EXCEL as an opportunity for patients to build camaraderie and reduce social isolation, especially for African Americans with diabetes.

Resource and Capacity Challenges for the Peers Excel Program

Organizational limits have become a major issue as stakeholders shared their concerns that the Peers EXCEL program may not receive sufficient resources. The resource-intensive aspects of patient recruiting, session arrangement, and food coordination require more staff than are currently available. Stakeholders highlighted concerns about scheduling, emphasizing the need for maximum flexibility and optimal timing of sessions to accommodate participants throughout the 8-week program.

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Overcoming Logistical Challenges for Program Participation

Study participants faced logistical challenges in addition to recruiting issues caused by participant distrust and program unfamiliarity. The Midwest’s low African American population compounded these issues. Organisational leaders stressed the importance of program financial feasibility. The recommendation was to charge a small fee to increase participant engagement and retention. Refreshments and transportation to program sessions were crucial to participant satisfaction.


Wen, M., Maurer, M. A., Schwerer, L., Sarkarati, N., Egbujor, U. M., Nordin, J., Williams, S. D., Liu, Y., & Shiyanbola, O. O. (2022). Perspectives on a novel culturally tailored Diabetes Self-Management Program for African Americans: A qualitative study of healthcare professionals and organizational leaders. International Journal of Environmental Research and Public Health, 19(19), 12814. https://doi.org/10.3390/ijerph191912814