diabetes and cardiovascular disease. Heart disease is the leading cause of diabetes-related deaths. or suffer a stroke than people without diabetes. …
heHispanicpopulationintheUSMexicoBorderRegionsuffersdisproportionatelyfromhighratesofdiabetesandheartdiseaseInresponse,PfizerInccreated theAllianceforaHealthyBorder,aprogramdesignedtofightthesediseasesbyreducingtheriskfactorsassociatedwiththem,suchasobesity,highcholesteroland highbloodpressureTheAlliancecreatespartnershipswithfederallyqualifiedcommunityhealthcentersandhealthorganizationsintheUSandMexicotopromote bestpracticesinpreventingdiabetesandcardiovasculardisease Pfizerhascommittednearly45millionoverthreeyearstoprovidegrants,capacitybuildingandnetworkingresourcestofederallyqualifiedcommunityhealthcenters intheUSandhealthorganizationsinMexicoThegrantshelpestablishorexpandprogramsdesignedtopreventdiabetesandcardiovasculardiseaseamongtheHispanic populationalongtheUS-Mexicoborderandsupportarangeofeducationandpreventionactivities,includinghealthscreenings,nutritionclasses,weightmanagement classes,walkingclubsandcookinginstruction AllianceforaHealthyBorderencourageseachorganizationtobuildstrongerinternalandexternalnetworksamongLatinos,topursueprogramsthatareknowntolimit theprogressionofdiabetesandheartdiseaseandtohelpindividualsbecomebetterinformedaboutdiseaseprevention
TheAllianceispartneringwithTheUniversityofTexas-PanAmericantoevaluatetheeffectivenessofeachgranteesprogramSelectedhealthcentersandcommunity organizationswillprovidemeasuresthatcanbetrackedoverthefundingperiodtodemonstrateanychangesfromabaselinehealthstatusamongLatinosAchart containinginterimresultsisincludedonthefollowingpage
Thereisasignificantlinkbetween diabetesandcardiovasculardisease
Heart disease is the leading cause of diabetes-related deaths Approximately 65 of deaths among people with diabetes are due to heart attack and stroke Adults with diabetes are two to four times more likely to have heart disease or suffer a stroke than people without diabetes Diabetes and cardiovascular disease share a number of modifiable risk factors, such as overweight/obesity, hypertension and high cholesterol that can be attributed to poor nutrition and lack of regular physical activity
TheBorder Regionis definedas thearea62 milesnorth andsouthofthe US-Mexicoline
59 of Hispanics in the US live in the four border states Hispanics are the largest US minority group with more than 37 million people — or 133 of the total population Two-thirds are of Mexican origin By 2050, the US Hispanic
population is expected to grow to more than 102 million — or 24 of the total population 17 of the Mexican population resides in the six Mexican border states The Mexican border state population growth rate of 23 exceeds the overall country growth rate of 18
Theborderpopulationsuffersdisproportionately fromdiabetesandcardiovasculardisease
In the US, Hispanics are almost twice as likely to have diabetes than non-Hispanic whites Almost 16 of border residents suffer from diabetes, compared to 149 in Mexico and 139 in the US Nearly 14 of the border population is pre-diabetic In the US, cardiovascular disease accounts for 31 of all deaths in the Hispanic population 75 of Hispanics with diabetes do not know they are at risk of heart disease Deaths caused by cardiovascular diseases in Mexican men are almost 18 higher in the border region than in the rest of the country
the prOGram Will FOCuS On ten uS anD Six mexiCan CitieS
ariZOna
Nogales Tucson
CaliFOrnia
Calexico San Diego
neW mexiCO
Columbus Las Cruces/ SunlandPark
texaS
Eagle Pass El Paso Laredo San Juan
BaJa Chihuahua COahuila CaliFOrnia
Tijuana Cd Juárez Piedras Negras
nuevO leÓn
Sabinas
HidalgoAnahuac
SOnOra
Nogales
tamaulipaS
Nuevo Laredo
Grant SummarieS
Arizona
In 2002, approximately 4 of Arizonans had been diagnosed with diabetes If current diabetes rates remain the same, by 2020 there will be almost 300,000 people with diabetes in the state However, measures of diabetes prevalence, incidence, hospitalization and major risk factors indicate that current rates are worsening and the increase is seen across all ethnic and racial groups ElRioCommunityHealthCenter in Tucson is expanding its current diabetes services to target families at-risk for diabetes Through hiring and training health educators or promotoresas, El Rio will work with Hispanic families to learn how to avoid or delay the onset of diabetes The class curriculum includes the physiology of the body, how food affects blood-sugar levels, exercise and hygiene, as well as advice, directions and resources on diabetes In Nogales,MariposaCommunityHealthCenter is enlarging and improving its Salud Para Su Corazón For the Health of Your Heart program, which fosters heart health in the family and within the community at large Mariposa will retain and train promotoresas to provide outreach and education for
community members at risk for heart disease; to facilitate provider-patient interaction and communication; and to support goal-setting towards healthy lifestyle changes for a healthier heart
NewMexico
The New Mexico Department of Health ranks diabetes as the sixth leading cause of death among adults and estimates that one in two adults in New Mexico is overweight and has no regular physical activity, placing them at risk for developing diabetes DonaAnasBenArcherHealthCenter is expanding its current diabetes education and public awareness outreach program by hiring a full-time bilingual health educator and bilingual community health worker Health workers offer basic diabetes education and strategies for self-management, meet with patients during their clinic visit and provide follow-up to ensure that program participants maintain healthier exercise and eating habits LaClinicadeFamilia inLasCruces is broadening the services provided by its promotoresas to reach patients and their families who are at-high risk for diabetes Through regular, individual education sessions offered to families in their homes, promotoresas use the Su Corazón, Su Vida Your Heart, Your Life curriculum to
teach the importance of physical activity and how to modify lifestyles to become more physically active
Texas
An estimated 12 million adults in Texas have been diagnosed with diabetes Another 400,000 adults are believed to have undiagnosed diabetes bringing the total to over 16 million people with the disease It is the sixth leading cause of death in the state CentrodeSaludFamiliarLaFe in ElPaso is implementing a new program for adults called Nuestro Bienestar This program includes regular meetings with a pharmacist educator to cover a comprehensive diabetes education curriculum based on Salud Para Su Corazón For the Health of Your Heart as well as training on how to monitor sugar level and blood pressure Supplemental activities to educate family members about the importance of diabetes and cardiovascular health include exercise, cooking, nutrition and dance classes UnitedMedicalCenters in EaglePass is implementing a new program called Si Se Puede based on a modified version of the Pasos Adelante Steps Forward curriculum that includes lessons on nutrition, risk factors for cardiovascular disease, smoking cessation, and the importance of physical activity, as well as actual
physical activity after every class The program, aimed at preventing diabetes, cardiovascular disease, and other chronic diseases in Hispanic populations, is facilitated by community health workers LaredosGatewayCommunityHealthCenter is expanding one of its diabetes self-management programs, Amigos en Salud, to include prevention of diabetes and cardiovascular disease Gateway uses promotoresas to work with medical providers to identify and track patients diagnosed with mild or severe obesity The promotoresas provide group education sessions covering weight loss and management, healthy eating, stress management and smoking cessation In addition, the group 
s take part in physical activity, providing each other with support to implement the necessary lifestyle changes InSanJuan, NuestraClinicadelValle is branding a new program called Medir Para Vivir Measure to Live, targeting current patients of the clinic suffering from obesity The goal of the program is to maintain or improve the health of individuals at high risk of diabetes by preventing or delaying the onset of the disease through individualized nutrition education classes
California
Despite its nickname The Golden State, more
than one-quarter of Latinos in California rate their overall health status as fair or poor Cardiovascular disease is the leading cause of death statewide with diabetes causing 5 of deaths These numbers are expected to rise as the prevalence of diabetes increases In 2000, physical inactivity and obesity cost the state an estimated 217 billion through direct and indirect medical care, workers compensation and lost productivity ClinicasdeSalud in Calexico is implementing a new community outreach program aimed at reducing the prevalence of diabetes and cardiovascular disease among Hispanic men, women and children The program includes the implementation of the Pasos Adelante Steps Forward curriculum, which is aimed at preventing diabetes, cardiovascular disease, and other chronic diseases in Hispanic populations Clinicas de Salud will provide physical activities, promotoresas-based training, guest speakers, information on nutrition as well as lessons on healthy food preparation SanDiegosLaMaestraCommunityHealthCenter is working with patients who are either suffering from or at-risk of developing diabetes Health educators will assist participants with identifying positive ways to modify
their behavior, diet and lifestyle to prevent the onset of diabetes Those already diagnosed with diabetes are taught ways to better monitor and manage their condition The FamilyHealthCenters in SanDiego FHCSD is extending and expanding its current diabetes screening program called Wednesdays to Wellness A promotera works to screen patients in the community with the goal of identifying new at-risk individuals, who are then referred to health education classes and/or a physician For those newly diagnosed as at-risk, FHCSD offers group and/or individual health education sessions that cover diabetes, cardiovascular disease and related prevention or management strategies SanYsidroHealthCenter is building on Project SALSITA, its program for pediatric patients with cardiovascular disease and diabetic risk factors Project SALSITA is enhanced by offering a complete family risk assessment as well as improvements in the health education and lifestyle interventions offered to at-risk families
Juan and eva luna Nuestra Clinica del Valle, San Juan, Texas Geminis Peña, nutritionist, counsels Juan and Eva Luna Juan is pre-diabetic and Eva has had diabetes for 10 years They have replaced sugar
with a sugar substitute and because they dont have a car they walk everywhere
Cecilia navaro Clinicas de Salud del Pueblo, Calexico, California Exercise is an important part of the Pasos Adelante program Cecilia Navaro leading center lost 18 pounds during the eight-week program
Sample CharaCteriStiCS
BaselineSocioeconomicandHealthStatusProfile
Female hispanic no high school degree income 20,000 Good or better general health Diagnosed with diabetes Diagnosed with high cholesterol Program Sample 791 961 689 788 379 398 432 Nationwide Frequency 515 47 96 26 845 73 356
BaselinePhysicalActivityMeasures
Program Sample met healthy people 2010 recommendations 205 Nationwide Frequency 491
BaselineNutritionMeasures
Program Sample Fruit and vegetable consumption healthy habits scale 26 servings/wk 309 Recommended 35-63 servings/wk -
BaselineHealthMeasures
Program Sample Bmi hba1C Fasting glucose Cardiac risk ratio Nationwide frequency is based on 2005 BRFSS data Maximum possible score is 48 325 70 1286 25 Recommended 25 7 100 35
evaluatiOn Data
1,422 baseline data submissions Received by 4-15-07
164 six-month, post-program-end data submissions
640 program-end data
submissions
rodolfo Gaméz La Clinica de Familia, Las Cruces, New Mexico Promotora Margarita Jacquez takes Rodolfos blood pressure When the promotora community health worker provided Rodolfos first class at his home, his wife Maria became quite interested Eventually, she was screened for diabetes and is now being treated for the disease
esther Bolivar Mariposa Community Health Center, Nogales, Arizona Esther Bolivar encourages her friends and family to attend community health education classes Ive learned a lot about how to cook and eat healthy I bring all the information to my family so they can also be healthy I now have my blood pressure under control with the advice I learned from the classes
OutCOmeS Data
PhysicalActivityMeasures
met healthy people 2010 recommendations
After one year of grant and capacity building support, there has been educational and community outreach to more than 11,000 individuals University of Texas Pan-American has evaluated a subset of this population and has reported increases in healthy eating habits and exercise, resulting in weight loss and lower blood sugar levels
Baseline to Program End proportion of participants meeting goal increased at 7
of 11 centers 3 centers with statistically significant change improvements between 12 - 32
Baseline to Six-months after Program End proportion of participants meeting goal increased at 3 of 6 centers 1 center with statistically significant change 28 improvement
NutritionMeasures
Baseline to Program End Baseline to Six-months after Program End participants from 3 of 6 centers increase fruit and vegetable consumption 2 centers with statistically significant change increase in meeting recommended weekly consumption between 47 - 154
Fruit and vegetable consumption
participants from 9 of 11 centers increase fruit and vegetable consumption 4 centers with statistically significant change increase in meeting recommended weekly consumption between 38 - 112
healthy habits scale
participants from 9 of 11 centers statistically significant increase
participants from 4 of 6 centers statistically significant increase
HealthMeasures
Baseline to Program End Baseline to Six-months after Program End average Bmi decreased for participants in 7 of 8 centers Decline of 53 at 1 center was statistically significant average hba1C decreased for participants at 3 of 7 centers Decline of 88 at 1
center was statistically significant
Bmi
average Bmi decreased for participants in 8 of 11 centers Declines at 3 centers were statistically significant decrease of 10 - 29
hba1C
average hba1C decreased for participants at 9 of 11 centers
Fasting glucose
Fasting glucose fell on average at 5 of 11 centers 2 centers reported statistically significant decline of 53 - 299
Fasting glucose fell on average at 4 of 8 centers 1 center reported statistically significant increase of 40 points; however average remained 1055 only slightly above the 100 point desired
Cardiac risk ratio
average ratios at 11 of 11 centers remained below desired level of 35 3 of 11 centers had statistically significant declines
average ratios at 6 of 6 centers remained below desired level of 35 1 center had statistically significant decline; 2 centers saw statistically significant increases
Maximum possible score is 48
AllianceforaHealthyBorderispart ofPfizersbroaderefforttoaddress healthdisparitiesnationwidePfizerhas acomprehensiveportfolioofprograms toprovidefreeordiscountedmedicines tolow-incomeoruninsuredpatients Formoreinformationpleasecall PfizerHelpfulAnswersat1-866-706-4200
orvisitwwwpfizerhelpfulanswerscom
Source:asonet.com
