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. 2005 Jan;2(1):A20.
Epub 2004 Dec 15.

Developing and adapting a family-based diabetes program at the U.S.-Mexico border

Nicolette I Teufel-Shone  1 , Rebecca Drummond, Ulrike Rawiel
Affiliations

Developing and adapting a family-based diabetes program at the U.S.-Mexico border

Nicolette I Teufel-Shone et al. Prev Chronic Dis. 2005 Jan.

Abstract

Context: The prevalence of diabetes among Hispanics is more than twice that of non-Hispanic whites in communities along the U.S.-Mexico border. The University of Arizona and two community health agencies on the Arizona border, Campesinos Sin Fronteras and Mariposa Community Health Center, collaborated to design, pilot and assess the feasibility of a lay health-outreach worker- (promotora-) delivered diabetes education program for families. La Diabetes y La Unión Familiar was developed to build family support for patients with diabetes and to teach primary prevention behaviors to family members.

Method: Community and university partners designed a culturally appropriate program addressing family food choices and physical activity, behavior change, communication, and support behaviors. The program offers educational content and activities that can be presented in home visits or multifamily group sessions. Community partners led the implementation, and university partners guided the evaluation.

Consequences: Seventy-two families (249 total participants) including children and grandchildren participated. Preintervention and postintervention questionnaires completed by adults (n = 116) indicate a significant increase in knowledge of eight diabetes risk factors (P values for eight factors range from < 001 to .006) and a significant increase in family efficacy to change food (P < .001) and activity behaviors (P < .001). Interviews with participants highlight the program's positive psychosocial impact.

Interpretation: Community and university collaboration involved building upon the promotoras' expertise in engaging the community and the university's expertise in program design and evaluation. A promotora-delivered family-based diabetes prevention program that emphasizes family support, communication, and health behaviors is feasible and can yield change in family knowledge, attitude, and behavior relative to diabetes risk factors.

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Figures

A logic model illustrates the family component of the diabetes control and prevention program at the U.S.-Mexico border. An arrow points from 'Intervention Activities' to the box 'Family Skills and Chacteristics' with the words 'Build' and 'Reinforce' to show how the intervention seeks to build and reinforce skills and characteristics as communication, collective esteem and collective efficacy (as described in text). Another arrow points from 'Intervention Activities' to the box 'Family Behaviors' with the word 'information' to show how providing information can impact family behaviors on food choices and physical activity. The arrow leading from 'Family Skills and Characteristics' to the arrow between 'Family Social Behavior' and 'Family Health Behaviors' shows how family heath behaviors are shaped by family social behaviors, skills, and characteristics. An arrow between 'Family Social Behaviors' (described in text) and 'Family Health Behaviors'show how social behaviors impact behaviors such as food choices and physical activity. An arrow leads from 'Family Health Behaviors'to 'Family Health Outcomes,' which include nutrient intake, activity level, and diabetes prevention or management (described in text).
Figure
A family-based diabetes control and prevention program at the U.S.-Mexico border.
See this image and copyright information in PMC

References

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