Neighborhood Diabetes Education Program A Diabetes education curriculum for adults in East Harlem, NYC. Jasmin M. Harpe, MPH, Rosalyn Chan MD, MPH, MacKenzi Hillard, MD. ABSTRACT This group-based, participant directed diabetes education pilot program using the American Diabetes Association (ADA) guidelines was successful in increasing health literacy as well as reducing BMI among a black and Latino population in East Harlem, NYC. Average weight loss after completion of the program was 9.8 pounds with a mean starting BMI of 29.08 and mean BMI of 27.46 upon completion of the program with a composite weight loss of 47 lbs (n=5). Barriers to adopting healthy lifestyles reported by participants included: high costs of healthy and fresh food, cultural cooking practices, lack of information, fear of change and the normalcy of diabetes in their communities. Qualitative surveys of health and diabetes literacy at the end of the program found an improvement in the following domains: diabetes prevention, benefits of improving blood pressure control, meal planning, BMI and long term complications of diabetes in 80% of participants. This small pilot program for an adult diabetes curriculum found promising results for weight reduction and adoption of healthy eating, exercise and nutrition by employing guidelines from the ADA with participants goals in a small, focus-group atmosphere. BACKGROUND Health Disparities among Diabetics • The prevalence of diagnosed diabetes among adults in NYC is higher than the nationwide prevalence. • Black and Latino neighborhoods in NYC are plagued with higher rates of diabetes diagnoses • 31.0% of non-Hispanic blacks. • 28.0% of Hispanics. • Diabetes in this population is associated with significant morbidity and mortality: stroke, cardiovascular disease, renal failure, neuropathy, retinopathy. OBJECTIVES • To create a sustainable diabetes education curriculum for parents of MAChO students that increases health literacy using ADA guidelines and participant goals. • To reduce BMI among participants. • To incorporate the MAChO adult curriculum with the child curriculum. METHODS • Parent participants were recruited over a period of 3 weeks during MAChO program sessions for children. Surveys about health literacy were administered at the beginning and end of the program. • Flyers were distributed in the East Harlem neighborhood surrounding the Hunter-Silberman School of Social Work as well as at local clinics. Participants were given flyers to distribute to friends and family members. • Weekly diabetes education sessions were conducted with weigh-ins and phone check-ins in between sessions. • The curriculum focused on three subject areas: nutrition, weight loss and exercise. Sessions on the core subject areas were shaped by participant interests and goals. RESULTS • Average weight before the program was 171.1 lbs with a mean BMI of 29.08. • BMI ranged from 18.2 – 37.4. • Mean weight loss was 9.4 lbs with a range of 5-17 lbs. • Mean post BMI 27.46 with a composite weight loss of 47 lbs. • 4/5 participants reported via survey (1-5) an improvement in the following domains: diabetes prevention, benefits of improving blood pressure control, meal planning, BMI and long term complications of diabetes. RESULTS CONCLUSIONS • This group based diabetes education pilot program was successful in increasing health literacy as well as reducing BMI among a black and Latino population in East Harlem, NYC. • Small changes worked for participants’ weight loss i.e. food substitutions and walking instead of taking the subway. • Unique barriers for this population for diabetes prevention including high costs of food, cultural cooking practices, lack of information, fear of change and the normalcy of diabetes in their communities. Participant Quotes “I used to drink 3-4 canned sodas per day. Now I only drink soda if I am at an event or party.” “I take the stairs at work instead of the elevator now.” “I have cut back eating out at the restaurant to once every two weeks instead of once a week.” “I walk to the train now instead of taking the bus to the train.” “I have a sweet once a day for my sugar craving instead of three times a day.” “I stopped frying food and I prepare more vegetables like asparagus with olive oil.”
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Neighborhood Diabetes Education ProgramA Diabetes education curriculum for adults in East Harlem, NYC.
Jasmin M. Harpe, MPH, Rosalyn Chan MD, MPH, MacKenzi Hillard, MD.
ABSTRACTThis group-based, participant directed diabetes education pilot program using the AmericanDiabetes Association (ADA) guidelines was successful in increasing health literacy as well asreducing BMI among a black and Latino population in East Harlem, NYC. Average weight lossafter completion of the program was 9.8 pounds with a mean starting BMI of 29.08 and meanBMI of 27.46 upon completion of the program with a composite weight loss of 47 lbs (n=5).Barriers to adopting healthy lifestyles reported by participants included: high costs of healthyand fresh food, cultural cooking practices, lack of information, fear of change and the normalcyof diabetes in their communities. Qualitative surveys of health and diabetes literacy at the endof the program found an improvement in the following domains: diabetes prevention, benefitsof improving blood pressure control, meal planning, BMI and long term complications ofdiabetes in 80% of participants. This small pilot program for an adult diabetes curriculum foundpromising results for weight reduction and adoption of healthy eating, exercise and nutritionby employing guidelines from the ADA with participants goals in a small, focus-groupatmosphere.
BACKGROUNDHealth Disparities among Diabetics
• The prevalence of diagnosed diabetes among adults in NYC is higher than the nationwideprevalence.
• Black and Latino neighborhoods in NYC are plagued with higher rates of diabetes diagnoses• 31.0% of non-Hispanic blacks.
• 28.0% of Hispanics.
• Diabetes in this population is associated with significant morbidity and mortality: stroke,cardiovascular disease, renal failure, neuropathy, retinopathy.
OBJECTIVES• To create a sustainable diabetes education curriculum for parents of MAChO students that
increases health literacy using ADA guidelines and participant goals.
• To reduce BMI among participants.
• To incorporate the MAChO adult curriculum with the child curriculum.
METHODS• Parent participants were recruited over a period of 3 weeks during MAChO program sessions for
children. Surveys about health literacy were administered at the beginning and end of the program.
• Flyers were distributed in the East Harlem neighborhood surrounding the Hunter-Silberman Schoolof Social Work as well as at local clinics. Participants were given flyers to distribute to friends andfamily members.
• Weekly diabetes education sessions were conducted with weigh-ins and phone check-ins in betweensessions.
• The curriculum focused on three subject areas: nutrition, weight loss and exercise. Sessions on thecore subject areas were shaped by participant interests and goals.
RESULTS• Average weight before the program was 171.1 lbs with a mean BMI of 29.08.
• BMI ranged from 18.2 – 37.4.
• Mean weight loss was 9.4 lbs with a range of 5-17 lbs.
• Mean post BMI 27.46 with a composite weight loss of 47 lbs.
• 4/5 participants reported via survey (1-5) an improvement in the following domains: diabetes prevention, benefits of improving blood pressure control, meal planning, BMI and long term complications of diabetes.
RESULTS
CONCLUSIONS• This group based diabetes education pilot program was successful in increasing health
literacy as well as reducing BMI among a black and Latino population in East Harlem, NYC.
• Small changes worked for participants’ weight loss i.e. food substitutions and walking instead of taking the subway.
• Unique barriers for this population for diabetes prevention including high costs of food, cultural cooking practices, lack of information, fear of change and the normalcy of diabetes in their communities.
Participant Quotes“I used to drink 3-4 canned sodas per day. Now I only drink soda if I am at an event orparty.”“I take the stairs at work instead of the elevator now.”“I have cut back eating out at the restaurant to once every two weeks instead of once aweek.”“I walk to the train now instead of taking the bus to the train.”“I have a sweet once a day for my sugar craving instead of three times a day.”“I stopped frying food and I prepare more vegetables like asparagus with olive oil.”
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