301892
Using spatial analysis to choose pilot neighborhoods for diabetes intervention in Durham, NC
According to the American Diabetes Association, 11.3% of the US adult population had diabetes in 2010, with an estimated annual cost of $218 billion. Through a grant from the Bristol-Myers Squibb Foundation, the Durham Diabetes Coalition is working to reduce the burden of diabetes in Durham County, NC.
Objective
Using spatial methods to characterize the geographic distribution of diabetes patients, community resources, and socioeconomic status across the county, we identified potential pilot neighborhoods.
Methods
We created a spatial data architecture that leveraged over 300,000 patient electronic health records (EHR) from Duke University Medical Center and Lincoln Community Health Center, census data, business location data, and information on community resources and partners. Spatial site selection methods considered the burden of type 2 diabetes, lack of healthy eating options, and the presence of a strong community base. Potential pilot areas were presented to a Community Advisory Board, which made the final selections.
Results
Three pilot neighborhoods were chosen for initial intervention programs. The first pilot neighborhood is located in south-central Durham, based around the strong community presence of a well-respected religious institution. The second pilot neighborhood chosen is a historically minority and low socioeconomic neighborhood. The third pilot neighborhood is an area with a similarly low socioeconomic status and a strong community base. The strong community presence provides an important infrastructure on which to build successful interventions.
Discussion
Spatial data and spatial analytical methods can identify patterns in health and existing community resources which can inform interventions aimed at improving health outcomes for high risk populations. By leveraging clinical and contextual data to identify pilot neighborhoods, we can implement interventions for diabetes care and education in areas that are receptive to those interventions and in the greatest need. This replicable strategy allows us to effectively focus limited resources.
Learning Areas:
Chronic disease management and preventionImplementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Learning Objectives:
Define key elements of site selection for a pilot diabetes intervention
Describe the process of interacting collaboratively and iteratively with a Community Advisory Board
Discuss various methods for targeting under-served populations
Keyword(s): Geographic Information Systems (GIS), Community-Based Health
Qualified on the content I am responsible for because: I am the lead GIS Analyst for the Durham Diabetes Coalition. I have worked extensively in incorporating spatial methods into EHR data and community interventions. I was the lead architect of the site selection methods used in this abstract and interfaced with the Community Advisory Board to select pilot neighborhoods.
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.