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Healing in Houston Through “Faith and Diabetes”

By Amelia Dmowska and Ben Pallant

An innovative program in Houston empowers members of faith communities to lead diabetes education, peer support, and prevention efforts in their communities

When considering a typical diabetes care team, a few key individuals may jump to mind – a doctor, nurse, pharmacist, diabetes educator, dietitian or nutritionist, and perhaps a physical therapist and a few other healthcare professionals. Who is left out of this picture? “Your faith leader and you,’” says Ardis A. Reed, a Certified Diabetes Educator (CDE) from TMF Health Quality Institute, Austin, Texas and one of the main facilitators of the Faith and Diabetes Initiative’s “Congregational Health Leadership” training program.

By integrating faith into diabetes awareness and support, the Faith and Diabetes Initiative in Houston adds a new twist to the traditional diabetes care team. Lay members of various religious communities are trained to provide an evidence-based diabetes education curriculum, peer support, and prevention programs in their houses of worship, whether churches, mosques, synagogues or temples. The inaugural class graduated from this training program this month in Houston, with graduates sharing their plans to kick off diabetes support and management programs in their respective congregations and faith communities.

The Faith and Diabetes Initiative is part of Cities Changing Diabetes (CCD) – a program of Novo Nordisk that supports diabetes awareness, care, education, and prevention in twelve partner cities around the world. Houston, where over 30% of adults are affected by obesity and 15.6% have diabetes, was a natural choice to be CCD’s partner city in the US. With sprawling highways, limited public transportation, and a fast food density higher than the state of Texas and the US as a whole, Houston’s environment is not particularly conducive to health. Innovative solutions, including collaborations among public and private organizations that are catalyzed by CCD and put into action by the Houstonians themselves, seek to change this.

The evidence based Diabetes Self-Management Education and Support (DSMES) curriculum used for this Faith and Diabetes Initiative was developed by the Gateway Community Health Center, Inc, FHQC, in Laredo, Texas. Materials are provided in both English and Spanish with an interactive tool kit for the trainers to facilitate the activities. This is the first time this curriculum will be integrated into and delivered in faith-based organizations.

Why a faith-based program?

Previous research conducted by UTHealth School of Public Health under CCD indicated a lack of trust in the traditional healthcare system by many Houstonians, which led the CCD action group to consider creative methods to raise awareness and increase diabetes education in Houston. Faith-based communities and religious organizations presented promising opportunities to reach people where they’re at, as faith is a central part of Houston’s community for many residents. 42% of Houston residents report attending religious services at least once a week, and another 31% say they attend once or twice a month – this compares to national averages of 36% and 33%. Not only are the religious communities large in size, they are also exceptionally diverse – Houston is the most racially and ethnically diverse metropolitan area in the US with over 145 languages spoken.

“There are 20,000 communities of faith in Houston which represent a diverse, immense infrastructure,” said Stuart C. Nelson, Vice President of the Texas Medical Center’s Institute for Spirituality and Health, which hosted the Congregational Health Leadership training. “The opportunity is tremendous, with many potential avenues for growth and sustainability­.” The Faith and Diabetes Initiative’s first group of program participants, in fact, represented 13 different houses of faith and 7 denominations across Christianity, Islam, and Hinduism which, combined, serve more than 50,000 people. By our math, about 924,000 residents go to church weekly and in all, 1.6 million go at least monthly.

Beyond the robust infrastructure of religious communities in Houston, there is also a powerful connection between spirituality, community, and health. The Congregational Health Leadership training prepares participants to facilitate diabetes education and support programs with members of their own community – a group of people who already trust the program leader and who speak the same sort of language, something Ms. Reed calls “community talk” rather than “clinical talk.”

What does the Faith & Diabetes program look like?

By integrating tenets of religion into messages of health, wellness, and caring for the body, the learning often becomes more meaningful and personal. During the training, the future program leaders appreciate connections between their religious beliefs and wellness practices, including treating the body as a temple, eating in moderation during specific times, and encouraging healthy behaviors by example. The graduating cohort was excited to bring this understanding to their houses of faith. “I got involved because I wanted to do something for the church,” said one program graduate. “In the end, not only did I learn so much for myself about wellness, I also now have the chance to come back and tell other people. I am ready and excited to go back to my church and help improve the congregation’s lifestyles.”

The first graduating class of the Faith and Diabetes initiative.

Cost, transportation, child care, health illiteracy, and busy schedules are all common barriers to participation in diabetes education and support programs, which often see high dropout rates. The Faith and Diabetes Initiative seeks to overcome these barriers. The training program is free, as are the subsequent programs that these trainees offer in their own faith communities. Many participants noted that they plan to schedule their classes right after weekly religious services and in a space provided by their house of worship, helping remove obstacles related to time, transportation, and child care.

Most importantly, the program graduates will focus on strengthening a feeling of true community among members of their programs. 

By including group discussion and fun, interactive activities to demonstrate health concepts, the diabetes workshops will help groups bond through both learning and play. By emphasizing the connections to spiritual practice, these workshops also help groups bond through shared values and traditions.

The training program has already demonstrated the successes of group-based programming. Graduates emphasized the support and connection they felt with one another – something that kept them coming back to the training classes even when their lives became hectic. “This is a sisterhood,” one participant said about her cohort of all-female graduates. “We know that we have our support group here, and that we are not alone.”

“[Diabetes] is devastating our lives, our families, and the people we love. It takes a village – it really does. It requires community support, family support, and personal accountability,” said another.

What’s next?

With one class having graduated already, the Faith and Diabetes Initiative has much more in the works. In addition to providing continued support and mentorship to these graduates as they establish classes in their own faith communities, the Faith and Diabetes team is planning three more sets of workshop sessions this year. 

“We envision this cohort as being the beginning foundation for chronic disease prevention broadly conceived in the faith sector,” said Stuart Nelson.

With this first class alone potentially reaching over 50,000 congregants, it is clear that this foundation offers widespread potential. As one graduate shared, “What better place to begin a journey of healing than in our churches and in our hearts?”

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