How peer support can offer long-term help for people with diabetes

November is Diabetes Awareness Month. Tricia Tang, an Associate Professor in the Department of Medicine’s Division of Endocrinology, has teamed up with other health professionals to launch the Supporting Physical Activity, a Community Effort (SPACE) for South Asians. The project is an interactive website that promotes physical activity and healthy lifestyle behaviours in South Asians who have been diagnosed with type 2 diabetes or who are at risk of developing the disease.

We caught up with Dr. Tang to ask her more about the SPACE project, her interest in diabetes research and the importance of peer support for long-term self-management of diabetes.

Tell us about your background and what sparked your interest in diabetes research.drtang_250x250

My research instincts emerged in college when I noticed many of my female friends were making appointments to see a gynecologist. I grew up in a traditional Chinese family and it was not culturally appropriate to see the gynecologist until after marriage. This is the first time I wondered whether cultural traditions and beliefs could influence health behaviors and, if so, could these decisions compromise health outcomes.

After graduating college, I started a doctoral program in clinical psychology. My first research publication was, “The role of cultural variables in breast self-examination and cervical cancer screening behavior in young Asian women living in the United States.” This publication launched my career trajectory as a behavioral scientist focused on health promotion and disease prevention in ethnic minority, high risk and medically underserved populations.

Later, I shifted my focus from cancer to diabetes after I started my first faculty position at the University of Michigan Medical School. The reason I gravitated towards diabetes is because of the personal control patients can have in delaying the development of diabetes or its long-term complications by making positive lifestyle changes.

I have the honor and privilege of designing, conducting and evaluating culturally tailored behavioral interventions that equip patients with the knowledge, skills and tools they need to manage their diabetes effectively over the course of their lives.

How can peer support groups help diabetes care in economically disadvantaged or marginalized communities?

Diabetes is a lifelong condition, so it requires ongoing, education and support. While diabetes education programs delivered by health professionals have been shown to improve health outcomes, research shows that without continued self-management support, these initial gains are time-limited, lasting no longer than 6 months.

Peer support offers a flexible, accessible and low-cost approach to providing long-term assistance in daily management, social and emotional support and linkage to clinical and community resources.

November 14 is World Diabetes Day. What is one thing you want people to be more aware of regarding this disease?

While depression and diabetes distress affect a large percentage of individuals living with diabetes, it is often overlooked and under-treated. Patients, particularly those from low-resource and marginalized backgrounds struggle with the unrelenting daily demands of self-management including adopting healthy eating habits, exercising, taking medications as prescribed, and monitoring. Psychological and behavioral support is critical to optimizing diabetes care. Without addressing the emotional aspects of diabetes, we are compromising a patient’s ability to manage their diabetes effectively.

You are currently involved in the Supporting Physical Activity, a Community Effort (SPACE) for South Asians. Can you tell us a little more about the project?

The goal of the project is to promote physical activity and healthy lifestyle behaviors in South Asians at risk and diagnosed with type 2 diabetes. To achieve this goal, we have developed culturally and linguistically tailored exercise tools that can be accessed through our website, SPACE. Translated in Punjabi, Hindi and English, the website includes four main features: exercise videos, activity tracking, Ask the Expert, and Eat Healthy.

The exercise video component offers 12 culturally appealing workouts including Bhangra dance, Bollywood aerobics, yoga, among others. The activity tracking allows individuals to set exercise goals and monitor their progress. The “Ask The Expert” feature invites users to ask any exercise or diabetes-health related questions and receive a response within 24 hours from our team of dieticians, nurses, pharmacists, psychologists and endocrinologist (the majority of whom are of South Asian background).

Finally, our “Eat Healthy” feature showcases healthy versions of traditional and contemporary South Asian dishes. Our intention is to generate enthusiasm and excitement about exercising and adopting healthy lifestyle habits in the South Asian community.

Bal Arneson from the Food Network’s Spice Goddess show recently donated eight healthy recipes to use on the SPACE website. If you had to choose one, which one would you recommend?

As many people may know, the North American version of the dish “butter chicken” is calorically dense and high in fat. At the Department of Medicine’s Research Expo last Wednesday, Chef Bal Arneson delivered a live cooking demonstration featuring her “no-butter” butter chicken. Over 50 audience members including myself had the opportunity to sample this “delicious, yet nutritious” dish. Not only was this a crowd pleaser and my top pick, but Chef Bal also revealed that this is her favorite recipe.

Dr. Tricia Tang is an Associate Professor in the Department of Medicine’s Division of Endocrinology and Affiliate Investigator at BC Children’s Hospital. She has been recognized for her contributions in research regarding health promotion and disease prevention in ethnic minority, high risk and medically underserved populations with the 2009 Distinguished Fellow from the National Institutes of Health, the 2003 and 2002 William N. Hubbard Endowed Fellowship Awards, the 1999 Jeffrey Tanaka Memorial Dissertation Award and the 1997 Women of Color Psychology Award.