Although further research is needed to establish the generalizability and durability over
time of the demonstrated positive effects of this intervention, our initial outcomes are
promising. Moreover, our results lend support to the growing body of literature and recommendations
of tailoring health promotion interventions to the sociocultural context in
which patients must negotiate their self-care on a daily basis (Osborn & Fisher, 2008).
Future work should specify the most valuable IMB model–based intervention content
needed to initiate and sustain diabetes self-care behaviors across different patient samples.
Although we anticipate the general content of the current intervention and its underling
theoretical model could be articulated to a number of diverse populations, we strongly
support a close examination of the extent to which the intervention and/or model can speak
to the cultural beliefs and systems that influence diet, food choice, and physical activity
across populations. Improvements to the current intervention include extending the contact
time to >90 min, expanding the amount of time spent on exercise, evaluating effectiveness
for longer than 3 months, and including both content to address and assessments to monitor
the impact of the intervention on depressive symptoms, blood pressure, lipids, weight,
and other diabetes self-care behaviors.