Diabetes screening and prevention in a high-risk, medically isolated border community

Ann V. Millard, Margaret A. Graham, Nelda Mier, Jesus Moralez, Maria Perez-Patron, Brian Wickwire, Marlynn L. May, Marcia G. Ory

Research output: Contribution to journalArticlepeer-review

23 Scopus citations

Abstract

Introduction:A project in a Texas border community setting, Prevention Organized against Diabetes and Dialysis with Education and Resources (POD2 ER), offered diabetes prevention information, screening, and medical referrals. The setting was a large, longstanding flea market that functions as a shopping mall for low-income people. The priority population included medically underserved urban and rural Mexican Americans. Components of the program addressed those with diabetes, prediabetes, and accompanying relatives and friends. Background:People living in the Lower Rio Grande Valley (LRGV) face challenges of high rates of type 2 diabetes, lack of knowledge about prevention, and inadequate access to medical care. Recent statistics from actual community-wide screenings indicate a high diabetes prevalence, 30.7% among adults in the LRGV compared with 12.3% nationwide. methods:A diverse team composed of public health faculty, students, a physician, a community health worker, and community volunteers conceived and developed the project with a focus on cultural and economic congruence and a user-friendly atmosphere. The program provided screening for prediabetes and diabetes with a hemoglobin A1c test. Screening was offered to those who were at least 25 years of age and not pregnant. When results indicated diabetes, a test for kidney damage was offered (urinary albumin-to-creatinine ratio). A medical appointment at a community clinic within a week was provided to those who tested positive for diabetes and lacked a medical home. Health education modules addressed all family members. discussion:The project was successful in recruiting 2,332 high-risk people in 26 months in a community setting, providing clinic referrals to those without a doctor, introducing them to treatment, and providing diabetes prevention information to all project participants. Implications for research and practice are highlighted. Conclusion:This study shows that a regular access point in a place frequented by large numbers of medically marginalized people in a program designed to eliminate cultural and economic barriers can succeed in providing a hard-to-reach community with diabetes prevention services. Aspects of this program can serve as a model for other service provision for similar populations and settings.

Original languageEnglish (US)
Article number135
JournalFrontiers in Public Health
Volume5
Issue numberJUN
DOIs
StatePublished - Jun 12 2017

Keywords

  • Diabetes
  • Diabetes education
  • Diabetes prevention
  • Health disparity
  • Hispanic
  • Latino
  • Mexican american
  • Prediabetes

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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