The Community Health Improvement Process for Montgomery County, Maryland
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Ranking Evidence-Based Practice
Description "Every Little Step Counts" was an effort to create a culturally appropriate healthy lifestyle education program for Latino children at highest risk for type 2 diabetes in the Phoenix, Arizona area. Participants were referred to the clinic from local school nurses. They were required to have a BMI in the 95th percentile or higher and also had to meet other criteria based on the American Diabetes Association's screening recommendations for type 2 diabetes in youth. Before enrolling in the program, laboratory testing for insulin resistance and cholesterol levels was performed. The initial appointment included a discussion of medical history and a physical exam.

Following the exam, children and their parents attended culturally appropriate healthy lifestyle education classes that dealt with issues such as the connection between weight, health, nutrition, and diabetes, roles and responsibilities of the children and their families around communication and health, education about and encouragement of physical activity, self-esteem and self-efficacy for making healthy decisions, and developing an individual healthy behavior plan and strategies for behavior change. Approximately three months after the end of the classes, participants returned for a one-on-one appointment with a dietician where challenges in maintaining behavior change were discussed. Children continued with follow-up sessions on problem solving, dietary adjustments, and other counseling.
Goal / Mission To create a culturally appropriate healthy lifestyle educational program for Latino children at highest risk for type 2 diabetes
Results / Accomplishments Of the 102 initial enrollees, 60.6% had elevated fasting insulin levels, 9.4% had impaired fasting glucose, 32.1% had high triglyceride levels, 39.4% had high total cholesterol, 68.6% had low HDL cholesterol, and 43.0% had high LDL cholesterol. The 50 youth who returned for post-intervention labs reduced BMI by 3.8% (p < 0.01) over an average of 13 months. They also reduced total cholesterol by 5.4% (p < 0.01) and LDL cholesterol by 8.6% (p < 0.01) and increased HDL cholesterol by 9.3% (p < 0.01). There was a decrease for fasting insulin of 24.0% (p < 0.05). There was no significant difference in the risk factors measured at initial enrollment for youth who completed follow up testing and those who did not.
Categories Health / Exercise, Nutrition, & Weight
Health / Children's Health
Health / Diabetes
Organization(s) St Vincent De Paul Medical & Dental Clinic; Arizona State University, College of Nursing & Health Innovation
Source Journal of Primary Care and Community Health
Date of Publication 9/30/2010
Date of Implementation 2005
Geographic Type Urban
Location City: Phoenix, AZ
Primary Contact Gabriel Q. Shaibi, PhD
Arizona State University, College of Nursing & Health Innovation
500 N 3rd Street, Phoenix, AZ 85004
gabriel.shaibi@asu.edu
http://sirc.asu.edu/
For more details http://www.ncbi.nlm.nih.gov/pmc/articles/PMC306...
Target Audience Children, Teens, Racial / Ethnic Minorities
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