Diabetes Block Captains: Genuine Community Engagement in the Battle Against Diabetes in a Poor and Medically Underserved Chicago Community

There is a significant gap in health worker models for effective diabetes intervention for African-American communities. Block by Block North Lawndale (B X B) is a comprehensive community-centered diabetes intervention in a very poor west side Chicago community. We trained and hired fulltime area residents to be community health workers, Diabetes Block Captains (DBCs) and to go door-to-door, screen for Type 2 diabetes and identify residents at risk for the disease. DBCs canvassed 2,500 households, completed 1,196 surveys, and found a neighborhood diabetes prevalence= 29.1%, three times the national rate. The DBCs lead an innovative intervention featuring 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 at least 0.5%. DBCs also train residents with diabetes to be community resources for self-care knowledge and social support. Peer support is built through a 16-week neighbor-to-neighbor Diabetes Learning Circle. To date over 40% of study participants have reduced their A1C levels (mean change -1.3%) and 60% of Diabetes Learning Circle (DLC) participants have improved glycemic control. DBCs encourage neighbors to talk about diabetes and work to make North Lawndale safer, improve access to quality foods and improve neighborhood cohesion. A detailed discussion of the CHW diabetes training curriculum, community outreach strategy, DLC program and CHW intervention model will be presented. In the end we believe that nothing substantial in such efforts can be gained without genuine community engagement. This is our mantra.