Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #115105

Renee E. Walker, Drexel University, 245 N. 15th Street, MS 660, Philadelphia, PA 19102, 215-762-6512, rew33@drexel.edu, Patricia Gerrity, Phd, RN, FAAN, College of Nursing and Health Professionals, Drexel University, Mailstop 501, 245 North 15th Street, Philadelphia, PA 19102, and Mariana Chilton, PhD, MPH, Department of Community Health and Prevention, Drexel University School of Public Health, 245 N. 15th Street, Mail Stop 660, Philadelphia, PA 19102.

BACKGROUND: The 11th Street Family Health Services of Drexel University is a community-based nurse managed health center that serves residents of four public housing developments in north Philadelphia. Of the 6,662 predominantly African-American adults in the area served by 11th Street, 14.7% have been diagnosed with diabetes. Diabetes in this population is often uncontrolled or poorly controlled. OBJECTIVE: This study focused on identifying factors that keep clients engaged in controlling their illness. Much of the burden associated with diabetes could be prevented with improved delivery of care, including diabetes self-management (DSM). The aim was to identify factors related to two elements of Wagner's Chronic Care Model (CCM) – community resources, and self-management support. DESIGN/METHODS: Four focus group discussions were conducted with 20 adults diagnosed with diabetes to identify and understand the socio-cultural, environmental, and familial contexts in which DSM occurs. Audiotaped recordings were transcribed and analyzed for themes. RESULTS: Preliminary results show that facilitators that contribute to DSM include ability to glucose self-test, transportation, fear of being ill or dying, having to raise grandchildren, and strong community support. Identified barriers include domestic abuse, community violence, and co-morbid chronic illnesses. CONCLUSION: Services offered at 11th Street that help clients remain engaged in their diabetes care were identified. These include the grandparents group, exercise classes, diabetes support group, and dental and podiatric services. Findings suggest that additional services that focus on co-morbid conditions, both physical and behavioral, are required to meet the complex needs of patients with diabetes.

Learning Objectives:

• To identify psychosocial, cultural, and environmental factors involved in diabetes self-management.
• To explore the barriers and facilitators to behavior change.
• To apply Wagner's Chronic Care Model in a community-based clinic.

Keywords: Community-Based Health Care, Diabetes

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.