256819 Block by Block: Neighborhood Cohesion, Activism and the Fight Against Elevated Diabetes Prevalence in North Lawndale

Monday, October 29, 2012

Joseph F. West, MSc, ScD , Sinai Health System, Sinai Urban Health Institute, Chicago, IL
Kristi L. Allgood, MPH , Sinai Urban Health Institute, Sinai Health System, Chicago, IL
Steve Whitman, PHD , Sinai Urban Health Institute, Sinai Health System, Chicago, IL
The growing prevalence of Type 2 diabetes in the US and its impact on African-American communities has been well documented. However, there is a significant gap in local survey data and models for effective intervention for these communities. Block by Block North Lawndale (B X B) is a comprehensive evidence-based diabetes intervention in a poor Chicago community based on local data collection. B X B trained and hired fulltime area residents to go door-to-door and screen for Type 2 diabetes and residents at risk for the disease. Block Captains canvassed 2,500 households, completed 1,196 surveys and discovered a prevalence of 29.1% (n=348). This is more than three times the national rate (310 residents identified as at risk for the disease). The community intervention featured individualized diabetes action plans, coordinated medical care, cooking, meal planning, and exercise classes, routine phone calls and home follow-up visits with the goal of reducing HbA1C by 0.5%. We analyzed baseline in-person survey data and found a mean HbA1c for women of 7.8% and men 8.0%. Type 2 diabetes status was associated with BMI, insurance status, family history and economic hardship. We also found an association between depressive symptomatology, HbA1c and self-management. Over 40% of study participants have thus far reduced their A1C levels (mean change -1.3%). This is very important as improved glycemic control (by at least 0.5%) is associated with lower healthcare utilization and costs and fewer diabetes complications and mortality. Detailed survey data, the intervention model and statistical analysis will be presented.

Learning Areas:
Planning of health education strategies, interventions, and programs
Provision of health care to the public

Learning Objectives:
1. Describe the performance level of community-based intervention in a medically underserved African American community. 2 Delineate the psychosocial and intervention variables that best explain the variance found in changes in HbA1C and measured diabetes self-care activities (e.g. healthy eating, physical activity, blood sugar testing, medication use, foot care, and smoking).

Keywords: Evidence Based Practice, Community-Based Public Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal or co-principal of federally and non-profit funded grants focusing on the epidemiology of diabetes and evidence-based interventions. Among my scientific interests are diabetes intervention, men's health and human development.
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.