227300 Land, food and health: Cultural-based education and chronic disease self-management

Monday, November 8, 2010

Sheryl Yoshimura, BS, RD , Kokua Kalihi Valley Comprehensive Family Services, Honolulu, HI
Jo-Hsi Wang, BS , Kokua Kalihi Valley Comprehensive Family Services, Honolulu, HI
Ritabelle Fernandes, MD, MPH , Kokua Kalihi Valley Comprehensive Family Services, Honolulu, HI
Mele A. Look, MBA , Department of Native Hawaiian Health, University of Hawai'i, John A. Burns School of Medicine, Honolulu, HI
Tricia Usagawa, BS , Department of Native Hawaiian Health, University of Hawaii, JABSOM, Honolulu, HI
Background: The high prevalence of diabetes in Native Hawaiians and Pacific Peoples (NHPP) has prompted the need for culture-based health education programs. Successful strategies for diabetes self-management programs are emerging but often do not incorporate the differing lifestyle, values and beliefs of ethnically distinct groups. Researchers in the field of education have shown culture-based education to be effective with indigenous and ethnically distinct populations. Kokua Kalihi Valley Comprehensive Family Services center (KKV) developed a culture-based diabetes self-management program tailored to their patient population. Healthy Eating and Lifestyles Program (HELP) uses culture-based education strategies and socio-emotional development to promote health educational outcomes. HELP builds on NHPP's foundational value of physical, emotional and spiritual relationship to land to engage and enhance chronic disease self-management.

Methods: HELP combined a once a month, six month classroom education with a twice a week communal garden as a physical activity component. The custom classroom curriculum was developed by KKV based on the American Association of diabetes educators' seven diabetes self-care behaviors.

Results: Preliminary data shows an average starting HbA1C level was 10.74 and after the program, HbA1C dropped to 9.39, a meaningful reduction of 1.34 (p<0001). Recent studies have shown that a reduction in HbA1C directly correlates to risk reduction. Participants reduced their risk of microvascular complications from diabetes and deaths related to diabetes by 37% and 21%, respectively.

Conclusions: Increases in cultural identity, self-worth through use of language, cultural content, and cultural context in health education can result in increased engagement, achievement and behavioral modification.

Learning Areas:
Chronic disease management and prevention
Diversity and culture
Planning of health education strategies, interventions, and programs

Learning Objectives:
1. Identify culturally appropriate strategies to promote healthy eating, active living, and self-management in low income patients with diabetes. 2. Describe components of effective models of health education and health promotion programs for indigenous populations.

Keywords: Health Education, Culture

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present on the content of this abstract because I am the program coordinator and health educator for this program.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.