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Abstract #163440

Kathleen Young, PhD, Department of Health Sciences, California State University, Northridge, 18111 Nordhoff Street, Northridge, CA 91330, 818-677-4725, kathleen.young@csun.edu, Joni Novosel, MA, Valley Care Community Consortium, 7515 Van Nuys Blvd., Van Nuys, CA 91331, and Audrey Simons, RDH, MSHA, Mission Community Hospital, 732 Mott Street, Suite 100, San Fernando, CA 91340.

Project ALTO (PA) a California-Endowment funded (2005) project of Mission Community Hospital, is a not-for-profit community-hospital in the San Fernando Valley area of Los Angeles. The goal of this project is to identify, educate, and screen low-income, uninsured Hispanics. PA identifies and screens individuals at community events and health fairs, referring low-income persons at high risk for diabetes and with no other access to care to MEND (Meeting Each Need with Dignity), local free clinics, staffed by volunteers and funded by all the hospitals within SPA 2. Collaborative partners include the Pacoima Diabetes Collaborative, funded (2006) to identify gaps in PA and to strengthen it. The Diabetes Collaborative provides health benefit screening at PA events, forms walking groups from interested community groups and is mandated to work toward identifying other community clinics with which to partner and to develop a group model for diabetes medical appointments, which allows clinics to increase their capacity without added costs. PA and the Collaborative work together providing diabetes education and health access to the community that each service. Key to the structural changes in the community has been the role that appropriately delivered, culturally sensitive disease management education has played in giving community members the information they need to better control their lives, communicate with their health care providers and understand the information that is given back to them.

Results of this 3 year program will be presented and discussed as well as future implications concerning structural change in communities through community-based partnerships.

Learning Objectives: At the conclusion of the session, participants will

• Identify collaborative building strategies that coordinate services related to prevention and treatment of obesity and diabetes among adults in Pacoima and Northeast San Fernando Valley area.
• Identify and discuss the importance of web-based resource directory development with information on diabetes/obesity-related services.
• Discuss a diabetes/obesity needs assessment and asset mapping instrument used for Pacoima and the San Fernando Valley (SPA-2). 4.1 Identify diabetes screening techniques and enrollment strategies such as coordinated outreach/enrollment activities with other LA-based enrollment entities. 4.2 Discuss the procedures for formal partnerships developments and/or MOUs with Pacoima and Northeast San Fernando Valley area clinics that can serve as medical homes to these individuals. 4.3 Develop strategies in order to link screened individuals in need of diabetes care and health benefits to medical homes. 5.1 Discuss a pilot "group visit model" at a clinic serving adults with diabetes. 5.2 Identify monitoring devices for the "group visit model" participants for provision of clinical diabetes tests including eye foot exams, cholesterol level, blood pressure level, and HbA1C levels.
• Identify and discuss established coordinated linkages with specialty, emergency, and hospital care for intended populations with Project ALTO and Neighborhood Legal Services, and the Diabetes Collaborative Steering Committee. 7.1 Develop strategies to increase levels of physical activity among diabetic adults and community residents by establishing three bilingual walking groups. 7.2 Develop ways to increase access to healthy and affordable food choices by establishing a community farmers market including nutrition information education.
• Discuss the results and future implications of the Project ALTO and Pacoima Diabetes Collaborative.
• Identify steps in order to develop effective structural change community-based partnerships.

Keywords: Community Collaboration, Diabetes

Presenting author's disclosure statement:

Any relevant financial relationships? No