537-P: Pilot Randomized Controlled Trial Outcomes from Examining What Can I Eat? Diabetes Nutrition Education and a Food Security Resource for American Indians with Type 2 Diabetes

Introduction and Objective: American Indians experience high rates of type 2 diabetes (T2D). Limited access to quality healthcare and healthy food can impact American Indians’ ability to manage T2D. We developed a classroom-based, culturally-tailored, ADA-sponsored diabetes nutrition education curriculum, entitled “What Can I Eat?” Healthy Choices for American Indians and Alaska Natives with T2D (WCIE). We evaluated the impact of engaging in WCIE classes augmented by a food security resource (FSR) which was a weekly $30 grocery gift-card for 12 weeks.

Methods: We conducted a pilot 3-arm randomized controlled trial for American Indian adults with T2D (n=67) at one urban Indian clinic. Treatment arms for the 3-month intervention included: WCIE+FSR; WCIE alone; FSR alone. Clinical measures, surveys, and 24-hour diet recalls were collected at baseline and 3 months. We evaluated outcomes at 3 months using Chi squared and Kruskal Wallis tests and linear mixed models.

Results: WCIE class attendance (90%) and retention at 3-month assessments (93%) was high. No changes were seen in clinical outcomes or food security however self-efficacy for healthy eating (mean changes= 0.3-0.6, p<0.05), and use of the ADA diabetes plate method (mean changes= 0.7-1.0, p<0.05) improved in all groups. Though all 3 groups improved in dietary behavior, the WCIE+FSR group experienced the greatest improvement on the Healthy Eating Index (50.4 from 47.2) compared to the WCIE alone (53.0 from 50.4) and FSR alone (56.0 from 55.1), though results were not significant.

Conclusion: WCIE can improve healthful eating behavior and self-efficacy and could augment comprehensive diabetes self-management education and support.