Developing community-based strategies to reduce obesity and diabetes in East and South Los Angeles utilizing multiple methodological techniques

Background: Obesity and overweight has reached epidemic proportions nationally. Los Angeles County is one of the epicenters for this public health crisis. Over 50% of the county's adult population and 40% of children are overweight or obese, which leads to various chronic diseases including type 2 diabetes. Methods: Multiple methodological assessments were utilized to pinpoint the socio-cultural and environmental factors that contribute to obesity. Data collection methods included: 1) qualitative interviews with 110 community leaders and residents, 2) inventory of 61 grocery stores, 3) systematic observations of community parks, 4) community resource mapping, 5) geospatial analysis of fast food venues relative to schools, and 6) random digit dial telephone survey (250 residents in each targeted community). Results: The Keck Diabetes Prevention Initiative and its Community Advisory Boards utilized community assessment findings to develop community-based strategies to reduce obesity and diabetes in two high-risk communities of Los Angeles (South LA – 90059 and East LA – 90022) Results provided insight to the pivotal role food plays within families, their social networks and local formal and informal economies. Several barriers to healthy eating and physical activity were identified including: lack of knowledge, safety in public parks, limited resources and, stress induced by poverty, low literacy, violence, and disenfranchisement. Strategies were unique to each community, however, both had specific interventions that were family-focused, culturally and linguistically relevant, involved cooking demonstrations, included day care, increased physical activity opportunities and access to healthy foods, and focused on improving physical activity, nutrition education and food services in schools.