This study evaluates the effectiveness of a culturally relevant intervention, delivered over 12 months on knowledge of colorectal cancer and participation in fecal occult blood testing. An experimental, repeated measures design was used. Free fecal occult blood testing was offered to the participants. Fifteen senior centers were randomly selected and assigned to the Cultural and Self-Empowerment Group, the Modified Cultural Group, or the Traditional Group. Their mean age was 73.83 years, and their average educational level was 8.8 years. The majority was African American, female, and reported annual incomes < or = 10,000 dollars. Data were collected at baseline, at 6 months, and at 12 months. Participants in the Cultural and Self-Empowerment Group had a significantly greater increase in their knowledge of colorectal cancer over time. Group membership and knowledge of colorectal cancer were significant predictors of participation in colorectal cancer screening. Participants in the Cultural and Self-Empowerment Group and those with greater knowledge of colorectal cancer were more likely to participate in fecal occult blood testing at the end of the 12-month period. Similar strategies may be implemented in community settings and health care agencies to inform elders about colorectal cancer.

Diabetes self-management education programs are an essential strategy for improving health behaviors of adults with diabetes and, therefore, intermediate clinical outcomes. We conducted a retrospective observational study using a case:control design to estimate the impact of participation in a diabetes health education program on glycemic and lipid levels, accounting for nonrandom participation of adults with diabetes in the program ("regression to the mean"). Adults with diabetes in a group-model managed care organization who attended the diabetes health education program during the period January 1, 2003, through June 30, 2004 ("participants"), were randomly matched with 4 adults with diabetes who did not participate ("nonparticipants"). Participants (N=1991) and nonparticipants (N=7964) were matched on age group, gender, mean hemoglobin A1c (Hb A1c) (or low-density lipoprotein) in the 6 months prior to the class (or randomly selected index month for nonparticipants), and primary care practice where the patients received regular care. On average, participants had significantly (P < .05) worse glycemic and lipid levels in the 6 months prior to participation compared to nonparticipants. Participation in the diabetes education program significantly improved glycemic and lipid levels between baseline and follow-up periods above the improvement attributable to regression to the mean. For example, nonparticipants with baseline Hb A1c levels greater than 10.0% had improved Hb A1c levels of -1.7% (P < .01); however, among participants, mean Hb A1c levels improved an additional -1.6% (P < .01). Overall, the evidence suggests that participation in a multifactorial diabetes health education program significantly improved glycemic and lipid levels in the short-term, particularly among participants with extremely adverse Hb A1c or low-density lipoprotein levels prior to participation.