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Diabetes Prevention and Outreach Program a Translation of Diabetes Prevention within the Hispanic Co


... individualized review of activity, food diaries and 'Keeping Track of ... as 3 or more risk factors from the NIH list of risk factors for type 2 diabetes ... – PowerPoint PPT presentation

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Title: Diabetes Prevention and Outreach Program a Translation of Diabetes Prevention within the Hispanic Co

Diabetes Prevention and Outreach Program a
Translation of Diabetes Prevention within the
Hispanic Community
  • Oklahoma City County Health Department
  • Allyson Drain, MS, RD/LD
  • Allyson_Drain_at_occhd.org
  • 405-419-4052
  • CDC Chronic Disease Prevention
  • April 24th, 2009

Hispanics and Diabetes
  • Hispanic Americans are 1.7 times more likely to
    have diabetes than non-Hispanic whites of similar
  • 25 of Mexican American over 45 have diabetes.
  • Hispanics became the largest minority group in
    2003 and the largest uninsured group.

  • To implement a nutrition education program
    within the Hispanic community in order to prevent
    or delay the onset of diabetes in this high risk
  • Equip participants with the tools to modify
    habits in order to prevent diabetes so they could
    teach others the lifestyle changes

Diabetes Prevention Classes
  • Based on the National Institute of
    Health-Diabetes Prevention Program (NIH-DPP) Core
  • Conducted 12 one hour lifestyle classes
  • Provided exercise time after each class
  • Provided weekly individualized review of
    activity, food diaries and Keeping Track of
    Weight graph

Lessons that were modified
  • Welcome to the Program the connection
  • Idaho Plate Method
  • Healthy Eating lowering fat and meal planning
  • Being Active a way of life
  • 7. Negative Thoughts and Problem Solving
  • 9. Slippery Slope of Lifestyle Change

(No Transcript)
Intervention Recruitment
  • 829 participants screened from 6/07 to 10/08
  • screenings held quarterly
  • Screenings held at a large Spanish speaking
  • Spanish speaking news media has been our greatest
    source of free advertising

Intervention Screening
  • Community Screenings included
  • Anthropometrics, lipid panel, fasting glucose and
    blood pressure
  • An assessment of risk for diabetes
  • at-risk was defined as 3 or more risk factors
    from the NIH list of risk factors for type 2
  • (National Diabetes Information Clearinghouse

At screenings each participant received
  • Education regarding the results of labs and
    measurements collected
  • Referrals for medical and/or socioeconomic needs
  • Invitations to attend diabetes prevention classes
    if identified as at risk or

Numbers of Participants
  • 829 screened
  • 111 attended at least one class
  • 84 completed at least 6 of the 12 classes
  • Few of the participants attended the church where
    the screenings and classes were held

Screening Participation
Screening Participants BMI/Glucose
Medical Homes
  • Everyone who came to a screening that had a
    medical need was given a medical home they could
  • We utilized many different types of clinics
  • Health Alliance a free clinic association
  • Several sliding scale clinics
  • Doctors who agreed to see 1 patient a month free
    of charge

  • 84 completed at least 6 of the 12 classes
  • 3 men
  • 97 women
  • Min. age 24, Max. age 79, Age range 55
  • 96 Hispanic, 4 Non Hispanic

Participant Outcome Goals
  • Each participant was given 2 goals
  • Reduce weight by 5
  • Engage in 2 ½ hours of physical activity a week
  • This was modified depending on needs of

Program Goals
  • 50 will reduce weight by 5
  • 50 will lower fasting glucose by 5
  • 90 reduction in tobacco use
  • 30 cholesterol gt200 would reduce cholesterol by
  • 50 with blood pressure gt140/90 will reduce by 10

OutcomeChanges in Elevated Lipids
  • Reduction in LDL (gt130mg/dl)(n27)
  • 59.3 decreased LDL by gt20
  • Reduction in total cholesterol (gt200mg/dl)(n31)
  • 69 decreased cholesterol by gt10
  • 34 decreased cholesterol by gt20
  • Reduction in Triglycerides (gt150mg/dl)(n38)
  • 66 decreased Triglycerides by gt10
  • 47 decreased Triglycerides by gt20

OutcomeGlucose Changes
  • Reduction in Pre-Diabetes (100-125mg/dl)
  • Out of the 36 participating pre-diabetics 12
    (33.3) reduced glucose level to normal
  • 3 (8) pre-diabetics did not convert to normal
    but decreased fasting glucose more than 10
  • Reduction in all participants
  • 47 decreased fasting glucose by gt5 (n84)
  • 72 decreased fasting glucose (n84)

OutcomeWeight Loss
  • 90 of participants lost weight (n84)
  • 39 lost gt5 of body weight
  • 40 of obese lost gt5 (n44)
  • 30 of over weight lost 5 (n30)
  • 32 of normal weight lost 5 (n10)

Factors Impacting Acceptance
  • Time of day
  • Classes were translated to Spanish
  • 88 did not speak English
  • 48 had an elementary education or less
  • 84 did not finish high school
  • OK House Bill 1804
  • Reliance on Free advertising

Class Goals
Small sample size
Programmatic Changes
  • Changes have been made to help our program meet
    the community needs while serving a greater
    number of participants with less costs from the
  • Graduate volunteers are trained to teach classes
    within the community
  • Volunteer teachers help to recruit class members

Programmatic Changes
  • Reliance on change in weight and knowledge
  • Screening for health risks is voluntary and not a
    condition of classes participation
  • Using ADA screening tool since lab screening is
    not a condition of classes
  • Weekly dietitian consults will be by appointment
    only, no appointments have been made so far

New Program with Changes
  • At week 6 of the community lead classes have an
    average weight loss of 2.6 for all who attended
    at least 3 weeks
  • 2 classes are being held at the same location
  • 3 new sites will open summer 2009
  • Currently have 4 leaders that are teaching and a
    waiting list of others wanting to start train the
  • Focus groups are being held for other populations
    in May 2009

Thank you
  • Allyson Drain, MS, RD/LD
  • 405-425-4469
  • Allyson_Drain_at_occhd.org
  • Imran Ahmed, MD, MPH
  • 405-425-4437
  • Imran_Ahmed_at_occhd.org
  • Nancy Dayton, RN
  • 405-425-4469
  • Nancy_Dayton_at_occhd.org
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