# Community-Based Intervention to Improve Diabetes Outcomes in Older African American Women with Multi-Caregiving Burden

> **NIH NIH R21** · MEDICAL COLLEGE OF WISCONSIN · 2020 · $207,669

## Abstract

PROJECT SUMMARY/ABSTRACT
 African Americans (AA) with type 2 diabetes (T2DM) have a higher prevalence of diabetes, poorer
metabolic control, and greater risk for complications and death compared to Whites. AA Women (AAW) have a
higher rate of diabetes, higher prevalence of visual impairment, higher rate of end-stage renal disease, and
higher age-adjusted mortality rate compared to White women. While the reasons for higher diabetes-related
morbidity and mortality in AAW have not been clearly elucidated, multi-caregiving responsibilities, or the
provision of care (emotional, physical/tangible, financial, spiritual) to parents/grandparents,
children/grandchildren, significant others, and their larger community, is a significant barrier to effective
diabetes care and contributes to the higher disease burden and increased mortality in AAW with T2DM. This is
particularly true for AAW in the Sandwich Generation (adults in their 40s and 50s who are wedged between
elderly parents and adult children/grandchildren), and the Club Sandwich Generation (adults in their 50s and
60s, who are wedged between aging parents/grandparents, adult children, and grandchildren), where multi-
caregiving responsibilities have resulted in increased stress, poorer glycemic control, and suboptimal self-care
behaviors. In addition, there is limited evidence on effective interventions that address multi-caregiving burden
in inner city AAW with T2DM. Preliminary data from our group suggests that a community-based, nurse-
facilitated, group-based, peer-support intervention that incorporates storytelling, problem solving and
goal setting, coping strategies, and diabetes education and skills training may be effective in this
population. Therefore, we propose a pilot randomized study to test the feasibility and preliminary efficacy of a
novel, community-informed, multicomponent intervention on mitigating stressors associated with multi-
caregiving responsibilities to improve diabetes outcomes compared to diabetes enhanced usual care. The
long-term goal of the project is to identify effective strategies for improving metabolic control and reducing
diabetes complications and mortality rates in AAW with T2DM.

## Key facts

- **NIH application ID:** 10057597
- **Project number:** 1R21DK123720-01A1
- **Recipient organization:** MEDICAL COLLEGE OF WISCONSIN
- **Principal Investigator:** Joni Strom Williams
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $207,669
- **Award type:** 1
- **Project period:** 2020-08-11 → 2023-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10057597

## Citation

> US National Institutes of Health, RePORTER application 10057597, Community-Based Intervention to Improve Diabetes Outcomes in Older African American Women with Multi-Caregiving Burden (1R21DK123720-01A1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10057597. Licensed CC0.

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