270663 High Prevalence of Diabetes and Barriers to Diabetes Prevention in East Harlem

Monday, October 29, 2012

Carol Horowitz, MD, MPH , Departments of Health Policy and Medicine, Mount Sinai School of Medicine, New York, NY
Kezhen Fei, MS , Health Evidence and Policy, Mount Sinai School of Medicine, New York, NY
Guedy Arniella, LCSW , Department of Community Health and Outreach, Institute for Family Health, New York, NY
Mali Trilla , East Harlem Community Health Committee, Inc, New York, NY
Euny C. Lee, MS , Department of Health Evidence and Policy, Mount Sinai School of Medicine, New York, NY
Introduction: Modest weight loss can prevent or delay the onset of diabetes. A community-academic partnership in East Harlem, the epicenter of diabetes in New York City, aimed to assess and address factors that challenge diabetes prevention. Methods: Using a community-based participatory research approach, the diabetes prevention team tested overweight adults (with no known diabetes) for pre-diabetes using oral glucose tolerance testing, and surveyed them regarding dietary attitudes and behaviors. Results: Of the 598 people included, 60% had pre-diabetes and 10% had diabetes. They were female (84%), Latino (75%), uninsured (35%), 43% had less than a high school education and 39% lived in poverty. Many eat fast food more than weekly (45%) and never choose food based on calories (61%). Only 26% were confident reading food labels. Common barriers to eating healthy include taste (71%), cost (50%), being raised to finish everything on ones plate (69%), not finding healthy foods when eating out (60%), or when in a hurry (66%). Many (55%) leave the neighborhood to find healthy foods. Overall, 72% were food insufficient and 52% find it difficult to eat healthy.

Conclusions: Surprisingly, only a minority of overweight adults surveyed had normal glucoses. This rate of pre-diabetes among predominantly food insufficient Latina women is well above that cited in the literature. Common factors that could contribute to this finding include unhealthy eating related to barriers including cost, taste, upbringing and access. Community-partnered efforts can yield novel insights and build community capacity to lead culturally appropriate, sustainable diabetes prevention efforts.

Learning Areas:
Administer health education strategies, interventions and programs
Advocacy for health and health education
Assessment of individual and community needs for health education
Chronic disease management and prevention
Implementation of health education strategies, interventions and programs
Public health or related research

Learning Objectives:
Discuss the factors that impact obesity and pre-diabetes Analyze barriers to diabetes prevention and healthy eating Assess the prevalence of pre-diabetes

Keywords: Latino Health, Community Research

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the Project Manager for the Project HEED randomized controlled trial. I have managed recruitment and follow-up assessments and assisted with the data cleaning and analysis of Project HEED, our successful weight loss-diabetes prevention program, and other CBPR studies, and has extensive experience in leading collaborative teams and organization of our Community Action Board, and worked closely with our community partners and subcontractors: Union Settlement Association and the Institute for Family Health.
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.