From Knowledge to Action: Community-Based Strategies that Transform Diabetes Self-Management Among Black Adults with Type 2 Diabetes.

BACKGROUND

Black adults with type 2 diabetes (T2D) experience disproportionately higher complications and poorer outcomes compared with other racial/ethnic groups. Community-based, culturally tailored diabetes self-management education and support (DSMES) interventions aim to improve glycemic levels, adherence, and self-care behaviors, yet strategies influencing success and sustainability remain underexplored among Blacks with T2D.

OBJECTIVE

This scoping review examined implementation strategies in community-based educational interventions for Black adults with T2D, identified effective practices, highlighted challenges, and offered recommendations for program design and policy.

METHODS

PubMed, CINAHL, Scopus, and EMBASE were searched through November 2025 for peer-reviewed quantitative or qualitative studies in English focused on Black adults and culturally grounded DSMES. Two reviewers independently screened studies, extracted data, and assessed quality using the Mixed Methods Appraisal Tool (MMAT). The Arksey and O'Malley framework guided the review.

RESULTS

Thirteen studies met inclusion criteria. Most quantitative studies were of fair quality (40-60% MMAT criteria met), and the single qualitative study met 100% of the MMAT criteria for qualitative research. Interventions consistently improved diabetes knowledge, self-care behaviors, and psychosocial outcomes. Peer-supported and community health worker-led programs showed modest glycemic improvements. Faith- and church-based programs enhanced engagement, and structured lifestyle interventions integrating education, coping skills, and monitoring yielded clinically meaningful outcomes. Retention and long-term engagement were challenges, especially in extended or high-intensity programs.

CONCLUSION

Community-based, culturally tailored DSMES interventions are feasible and effective in improving self-care, knowledge, and engagement among Black adults with T2D. Future programs should emphasize cultural relevance, address adherence barriers, and report outcomes to support sustainable practice and policy.