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Community-based intervention for reducing diabetes health disparities in Hispanics

Marylyn M. McEwen, PhD, APRN, BC1, Marion K. Slack, PhD2, and Irene A. Gutierrez, BS2. (1) College of Nursing, University of Arizona, PO Box 210203, Tucson, AZ 85721-0203, 520-626-6926, mmcewen@nursing.arizona.edu, (2) Pharmacy Practice and Science, College of Pharmacy, University of Arizona, P.O. Box 210207, The University of Arizona, Tucson, AZ 85721-0207

Diabetes represents a major health disparity in the U.S. Hispanic population; 24% of Mexican Americans between 45 - 74 have diabetes. We report on outcome data from an interdisciplinary case management program at the U.S.-Mexico border. Based on the Omaha Systems Model, interdisciplinary teams of health professions students provide comprehensive services to a high-risk group of Hispanics diagnosed with and/or are at risk of developing diabetes. Students from the disciplines of nursing (N=13), pharmacy (N=17), social work (N=8), public health (N=7), nutrition (N=9), and medicine (N=1) provided services to 56 clients over a three-year period. The study population was 98% Hispanic, predominantly Catholic (80%), and while 29% had graduated from high school, 20% had less than a 7th grade education. The most frequently identified problems were in the psychosocial domain (33 %), while the health related behaviors domain accounted for (30%), physiologic (23%), and environment (14%). The mean number of problems identified per client was 7.3. Students provided a total of 866 interventions of which 44% were teaching, 31% case management, and 22% were surveillance. The average number of interventions per client was 15.5. Client outcomes assessed through the concepts of knowledge, behavior and status demonstrated significant (p< 0.05) improvements in all of the domains except for status in the physiological domain. We conclude that in a vulnerable Mexican American population the Omaha Systems Model facilitates comprehensive interdisciplinary case management that yields significant improvement in client outcomes.

Learning Objectives:

Keywords: Health Disparities, Diabetes

Related Web page: www.pharmacy.arizona.edu/outreach/ncns/idtraining/ncns.shtml

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.


The 132nd Annual Meeting (November 6-10, 2004) of APHA