Policy and Environmental changes to support active living and healthy eating among low income Mexican American communities

The University of Texas Community Outreach (UTCO) program works in four counties in South Texas with large Mexican American populations to prevent and control diabetes through community-based approaches. A key program strategy of UTCO is to conduct organizational activities leading to policy and environmental changes. These changes were reported for each county by a thorough process and outcome evaluation. In the program's first two years 47 policy and environmental changes were implemented. Examples of policy changes include vending machine restrictions of sugary drinks and foods and joint use agreements for community use of park space. Examples of environmental changes include establishing farmers markets and community gardens, providing designated space for physical activity and education activities, and placing prompts promoting physical activity and healthy foods. These changes were implemented with involvement from community leaders, policy makers, community health workers, and health coalitions. We will present details about the processes used for identifying, establishing and evaluating policy and environmental changes in community settings. Program outcomes indicate statistically significant improvements in HbA1c (7.9% decrease) among diabetic program participants and increased number of community participants meeting physical activity guidelines [AOR = 4.2 (95% CI 2.0-8.8)].