Monday, October 24, 3:00 p.m.-4:30
p.m.
Differences in Four-Year Health Perceptions and Preventive
Practices in Border Residents of Hidalgo County, Texas
Authors
M.A. Zuniga1; M. Conkling2; C. Blakely3;
B. James4.
1Medical College of Georgia, Augusta, GA;
2Texas A&M Health Science Center, School of Rural
Public Health, Bryan, TX;
3Texas A&M Health Science Center, School of Rural
Public Health, TX;
4Texas A&M Health Science Center, School of Public
Health, TX.
Background
The Integrated Health Outreach System Project is a 4
year initiative, jointly funded by the Robert Wood Johnson
Foundation and the Health Services and Resources Administration,
Bureau of Primary Health Care to explore how a community health
development approach which incorporates lay health workers (Promotoras)
can increase access to care and health status among residents of
low income, isolated communities (colonias) in Hidalgo County.
Methods
A household survey covering perceived health status,
preventive screenings, usual places of health care, and
community concerns was administered to 200 adults in each of the
three border Colonias. Survey respondents were selected randomly
by the selection of block groups, households, and residents
within households. The respondents were interviewed twice, once
in fall 2002 and again in spring 2005.
Results
A real or perceived change has occurred in how
accessible traditional health services are in these colonias. At
baseline access to medical services was felt to 'not be a
problem' in 24% of participants. While In 2005, intervention
group respondents reported 35%. Furthermore, reports of access
to medical services as a serious problem decreased from 46% at
baseline to 32% in '05. A similar shift occurred when asked
about access to dental and mental services services.
Participants reported a slight increase in regular check-ups by
doctor (From 59.6% to 64.8%); and Blood sugar test/diabetes
screening (From 54.7% to 62.2%). Study participants seen by a
project promotora reported having at least one preventive
screening in the last year in 89% of responses.
Discussion
Establishing baseline parameters to assess
interventions is a practical approach to measuring progress
towards community health improvements. The inclusion of promotoras to enhance access to health care information and
referral services seems to positively impact the percepetions of
health and services in study participants.
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Sowing Seeds of Hope
Author
M. Brooke, Perry County Health Department / Sowing Seeds of
Hope, Marion, AL.
Background
Perry County Alabama is one of America's poorest
countries with a major cardiovascular disease death rate of
358.8 and a death rate of 59.8 for renal failure in 2003.1
Sowing Seeds of Hope (SSOH) is an organization within the
rural community which aids in reaching marginalized people
including those isolated by poverty. SSOF was formed for the
purpose of improving the physical, economical, and social
environment of Perry County. Regarding physical needs, two of
the most prevalent diseases seen within the county are
diabetes mellitus and hypertension.
Methods
One of the goals of the Perry County Health
Department is to educate patients on their disease state(s) in
order to decrease potential complications due to the disease(s).
Since diabetes and hypertension go hand-in-hand, we feel that
it is important to hold clinics in order to educate patients
and help them monitor and prevent complications from the
disease(s).
Results
Each Monday a certified diabetes educator presents
information to patients about diabetes as well as ways to
monitor diabetes and prevent further complications. In
addition to the diabetes clinic, a hypertension clinic is held
each Wednesday. In this particular clinic, the patient gets
his/her blood pressure checked by a pharmacist or a pharmacy
student and is provided with counseling as well as handouts on
ways to reduce blood pressure in order to prevent common
difficulties associated with the disease. The education that
is given to the patient regarding blood pressure is based off
of the JNC-7 guidelines.
Discussion
In monitoring these specific diseases, we hope to
decrease the incidence of further complications such as renal
disease, retinopathy, strokes, and heart disease. In
decreasing these complications, this will lower the net cost
of medications, doctor visits, and hospital visits.
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Delta Rural Health Initiative and Fit for Life Network
Authors
H. Patterson1; S. Thompson1; P. Burnett1.
1Le Bonheur Children's Medical Center, Jackson, TN.
Background
The Delta Rural Health Initiative is a project
funded by the Tennessee Department of Health and Health
Resources and Services Administration through the Mississippi
River Delta Special Projects. The goal of the Initiative is to
reduce morbidity and mortality associated with diabetes, heart
disease, stroke, and cancer in six counties in rural, West
Tennessee. The Fit for Life Network is a formal, collaborative
network of multiple health care and social service agencies in
rural, West Tennessee that was developed as a result of
Initiative findings.
Methods
Le Bonheur works with agencies in the Network to
develop and implement prevention and intervention programs in
different counties to address the risk factors associated with
heart disease, diabetes, stroke, and cancer. The interventions
were developed based upon findings from the community surveys
and screenings, provider feedback, and research on effective
programs and include chronic disease management, pharmacy
assistance, Dining with Diabetes (a 4-week educational program
for diabetics and their caretakers), Lace Up for a Good Life
(a walking program that focuses on team building and friendly
competition), Henderson County Shapes Up (an 8-week nutrition
and fitness program), and Food and Youth Initiative or FYI
(classroom-based nutrition and fitness curriculum).
Results
FYI-Over 900 students participated and over 95%
increased knowledge about nutrition and fitness. Lace Up-Over
60% of participants reduced cholesterol; over 70% reduced
glucose; over 20% reduced blood pressure; Dining with Diabetes
- 67% reduced cholesterol; 83% reduced A1C; 72% lost weight;
72% reduced blood pressure; Henderson Shapes Up-over 50%
reduced cholesterol and glucose; 20% reduced blood pressure;
68% lost weight.
Discussion
With obesity, chronic disease and healthcare costs
on the rise, there is an increasing need for cost-effective,
successful, community programs to prevent morbidity and
mortality associated with chronic diseases. Our Network is
demonstrating that by working collaboratively, we can make our
communities healthier places.
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"Eat and Play the Native Way": Building Strength Through
Healthy Choices
Authors
D. Burley1; T. Gene1.
1Coconino County Health Department, Flagstaff, AZ.
Background
The Eat and Play the Native Way Program was
developed to provide physical activity and nutrition education
to kindergarten through third graders in the Navajo reservation
schools within Coconino County. It is currently set up as a 6
lesson series combining physical activity and nutrition
education. An extra component of the program is where students
are taught various Native American games.
Methods
The Eat and Play the Native Way Program was first
developed through a mini grant through the Arizona Department of
Health Services. Initially, the grant was supposed to fund a
year long program; however the program was so well received by
the reservation schools that its funding was continued. The
focus of the program is to develop a physical activity and
nutrition curriculum which includes an appreciation and
understanding of Native American culture. A goal of the project
is for teachers to have these lesson plans as additional
resources as part of their health education classes. A component
of the curriculum uses traditional Native American games that
helps depict the culture of Native Americans. Students receive
an understanding of the skills that were needed long ago to live
in harmony with the environment. The lessons are to help start a
ground work in the understanding of the importance of physical
activity and nutrition within the Native American culture.
Results
Within the first year, part of the curriculum had been
developed and tested with 5 schools and a total of 866 students
participating. The second year, the program wanted to focus on
finishing the development of the curriculum and decided to
downsize the participation of schools to three schools. This has
worked well in focusing on the lessons and working with the
students on a more one to one basis.
Discussion
The curriculum is scheduled to be finished within in
the next school year.
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