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APHA Scientific Session and Event Listing

Sally Fontamillas Shaw, DrPH¹, Bruce Nelson, MA¹, Robert Nicoloff, MD², AnneMarie Leos-Gomez, MA¹, Lee S. Berk, DrPH, MPH, FACSM³, James Westengard, BS⁴, Edward Fujimoto, DrPH⁵, and Gina Kwan¹. (1) Community Services, Glendale Adventist Medical Center, 1509 Wilson Terrace, Glendale, CA 91206, 818-409-8547, shawsf@ah.org, (2) Diabetes Care Center, Glendale Adventist Medical Center, 1509 Wilson Terrace, Glendale, CA 91206, (3) Dept. of Health Promotion and Education and Dept. of Pathology and Human Anatomy, Loma Linda University, School of Public Health and School of Medicine, Nichol Hall Room 1511, Loma Linda, CA 92350, (4) Department of Pathology, Loma Linda University Medical Center, School of Medicine, Loma Linda, CA 92350, (5) School of Public Health, Loma Linda University, Department of Health Promotion and Education, Loma Linda, CA 92350

An estimated 18.2 million people in the United States have diabetes mellitus; 41 million have pre-diabetes; and 5.2 million (nearly one-third) have yet to be diagnosed. Population-based and selective screening programs in community settings have been used to identify at-risk diabetics; however the CDC concluded that such programs have uniformly demonstrated low yield and poor follow-up. In addition, the use of finger-stick blood tests have produced inaccurate results and is strongly discouraged at such events by the American Diabetes Association. However, recently Glendale Adventist Medical Center (GAMC) implemented a screening strategy that allows for large-scale cost-effective pre-selection of high-risk subjects in target populations. A self-scored risk-assessment survey is utilized to prescreen community residents. Participants scoring above an identified threshold are considered to be at-risk for diabetes and are directed into clinical glucose tolerance assessment for diagnosis. Those who are diagnosed are referred to health/medical care. By avoiding the use of a meter test as a screening mechanism, and following up with an oral glucose tolerance test (OGTT), GAMC is able to reduce the false negatives and positives to near zero and dramatically increase the cost effectiveness of the strategy overall. Of the 2124 prescreened so far, 49% were identified as at-risk for diabetes. Of the 279 clinically screened using glucose tolerance testing, 15% were diagnosed with diabetes, and 19% were diagnosed with pre-diabetes. Our model demonstrates a comprehensive integration of public health through community outreach, risk screenings, and referral case management, into the traditional health care system.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• List 3-4 risk assessment strategies to reduce diabetes risk
• Describe the significance of using a prescreening survey to diabetes risk.
• Discuss the integration of public health strategies into a traditional health care system.

Keywords: Community Health Assessment, Diabetes

Presenting author's disclosure statement:

Not Answered