Table 2.

Theoretical Basis for A New DAWN Intervention Components

Theory and Construct	Intervention Component	Intervention Strategies
Social cognitive theory
Environment: external physical factors that influence behavior	Church-based group education Church diabetes advisor (CDA)	Select the church as comfortable and friendly environment that will facilitate learning. Implement program in participants' community church. Groups at each church are made up of congregants, family, and friends; family and friends are invited as guests to group sessions. Have participants interact with CDA by home telephone.
Situation: perception of the environment	Group sessions	Begin each session with a prayer (following format of other church meetings by including a spiritual component). Post general diabetes information, session topics, and recipes on A New DAWN bulletin board in church to raise awareness of diabetes.
Behavioral capacity: knowledge and skills to perform a behavior	Group sessions CDA telephone calls	Include in group sessions opportunities to learn and practice ways to decrease saturated fat and sugar in food preparation, include activity in daily living, manage stress, get social support, and solve problems. Include in each session a short physical activity segment and tasting of recipes or new foods. CDAs share information and successful strategies for diabetes self-management during telephone calls.
Observational learning: learning by watching actions of similar others	Group sessions CDAs	Community members (health professionals, such as dentists, pharmacists, podiatrists) lead selected group sessions. CDAs act as role models and group cofacilitators. (CDAs are church and community members with diabetes.)
Reinforcements: behavior responses that increase or decrease likelihood or reoccurrence	Physician Monthly goal setting CDA telephone calls	Have physicians recognize performance of patients and provide encouragement and feedback; use printed physician messages as source of encouragement. Give self-selected rewards for reaching goals as component of monthly goal setting. During telephone calls, have CDAs give praise and other forms of social support for positive behavior changes.
Self-efficacy: confidence in performing a behavior	Health counselor assessment and tailoring Group sessions CDA	Use short-term goal setting with small, achievable steps to facilitate changes in diet and physical activity behaviors; record on log sheets progress in increasing physical activity and controlling blood pressure and blood glucose. Share successes in changing behavior during sessions and with CDA during telephone calls. Perform different types of physical activity during group session. Use scenarios and hands-on activities to practice skills in making dietary and other behavioral changes.
Stages of change model	New Leaf Diabetes educational materials Health counselor assessment and tailoring	Use assessments and tip sheets to target different stages of readiness for behavior change. Have the health counselor develop individually tailored action plans using assessment data and input of participant; identify and address attitudinal barriers using brief assessments and corresponding tips for making behavior changes.
Adult learning theory	Group sessions	Have participants provide input on topics for group sessions. Use group discussions to encourage sharing of life experiences to facilitate learning and behavior change.
Social networks and social support	Church and community setting Group sessions CDA Physician	Invite families and friends to group sessions. Use church members as a community support unit. Have CDA make monthly telephone calls to enhance social support.Use printed physician messages to add social support value.
Community health development	Church and community setting CDA and Church Health Action Team (CHAT)	Solicit community input in development and implementation of intervention. CDA gains employment and develops skills in health communication, diabetes self-management, and behavior change strategies through training for position and cofacilitator role in group sessions. CHAT develops community resource list and plans church events to raise awareness of diabetes; CHAT learns skills in planning church health events through participation in planning workshop.