Building community capacity for diabetes self-management in the US-Mexico border region

Background: The impact of diabetes mellitus (DM) is devastating on the estimated 7.5 million adults who reside in the US-Mexico border region. Approximately 1.2 million adult border residents have Type 2 DM, the majority live on the U.S. side of the border, and are predominantly (70%) Hispanic. DM self-management challenges unique to Hispanics in the border region include a paucity of culturally competent DM self-management education programs, lack of DM-specific support from families and friends, higher poverty and lower literacy levels, and barriers to accessing culturally congruent care. We report on the processes and principles that underpinned a community-based participatory research (CBPR) study conducted with Mexican American adults who were concerned about the increased burden of Type 2 DM in their community in the Arizona-Mexico border region.

Methods: Multiple methods used to engage community members and researchers in a collaborative process included: key informant interviews, participation in neighborhood association meetings and a community-based coalition, and recruitment/participation of CHWs to deliver a multi-modal culturally tailored intervention for increasing DM self-management behaviors.

Results: Partnerships between researchers and community members created a health advocacy DM subcommittee, training of two community members as CHWs with expertise in diabetes, development of multiple community members and local businesses who are actively engaged in social action for decreasing DM health disparities, and building DM self-management capacity for individuals and their families related to nutrition, physical activity and diabetes stress management behaviors.

Conclusions: CBPR is a promising approach for mobilizing social action and building community capacity to address DM health disparities and challenges associated with DM self-management for Mexican American adults with type 2 DM in the US-Mexico border region.