256823 Diabetes Block Captains: Genuine Community Engagement in the Battle Against Diabetes in a Poor and Medically Underserved Chicago Community

Wednesday, October 31, 2012 : 8:30 AM - 8:50 AM

Joseph F. West, MSc, ScD , Sinai Health System, Sinai Urban Health Institute, Chicago, IL
Steve Whitman, PHD , Sinai Urban Health Institute, Sinai Health System, Chicago, IL
Margaret Shepard , Sinai Health System, Sinai Urban Health Institute, Chicago, IL
Roxanna Martinez , Sinai Health System, Sinai Urban Health Institute, Chicago, IL
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.

Learning Areas:
Chronic disease management and prevention
Implementation of health education strategies, interventions and programs
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 community health worker curriculum, key competencies 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: Community Health Advisor, 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 community-based interventions Among my scientific interests are diabets 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.