Community Influences on Diabetes Knowledge & Lifestyle of Individuals & Families

Community Influences on Diabetes Knowledge & Lifestyle of Individuals & FamiliesSharon A. Denham, PhD, RN, CNEProfessor, Houston J. & Florence A. Doswell Endowed Chair in Nursing for Teaching ExcellenceTexas Woman's University, College of Nursing

ObjectivesDescribe a funded project aimed at enhancing sustainable healthy lifestyles for families where persons are diagnosed with type 2 diabetes.Discuss ways the Family Health Model (Denham, 2003) was used to plan family & implement community interventions that affected lifestyle individual & family behaviors to manage & prevent type 2 diabetes.Identify outcomes of project efforts.

Vulnerable Population GOALs (CDC, 2010 - 2013)Developed community coalitions in four states (KY, MS, OH, VA) and 11 counties (3 regions) in the Appalachian regionStrengthen diabetes knowledge in all countiesMap county assets & develop strategic plansAddress type 2 diabetes preventionCreate sustainable activities to manage & prevent type 2 diabetesAppalachia

Family Health Model (Denham, 2003)Contextual perspectives - Family household/communityFunctional perspectives - Supportive relationshipsStructural perspectives - Family health routines

http://www.diabetesfamily.net/family/family-health-model/Socio- ecological PerspectiveFamily & community are connected11 County Town Meetings - Inform about the type 2 diabetes problem (individual, family, county, & Appalachia)Train- the - Trainer model - Local people teaching & supporting one another

Volunteers Diabetes CoalitionsListenBuild TrustShow Up - Be dependable

Project Year #1Coalition formation & development activities - Small amounts of money, multiple forms of support, genuine careCommunity education about the burden of type 2 diabetesLiving with diabetes in your family & community - 100 interviews conducted & filmedLessons learned: Invest time, build a positive community reputation, & listen.

Project Year #2 & #3Built upon prior effortsFilms (4) created & distributed in communitiesMusic CD created & distributed in communities

Other Activities - Year #2 & #3Healthy for GOoD Walking TrailsTurtle ChallengeKids Bucks

Church - Based ProgramsGain support of local ministers in each countyProvided two regional educational workshops annuallyOutcomes: Community involvement, community gardens, church suppers, weight loss, walking clubs, etc.Increased knowledge of type 2 diabetes risks, management, and prevention

Year #3 ActivitiesBuilt networks that involved health care providers Developed 4 week county diabetes education programs - supported by local health care services

PROJECT OutcomesEstablished supportive community networks outside traditional health care services.Community driven - Bottom up approach to the problemResult of strong (a) individual determination, (b) partnerships, (c) shared individual & community relationships, and (d) shared vision.Involved families

Lessons LearnedStart with a dedicated/committed groupValue in networking & collaborating with others in the communityNeed minimum of 3 to 5 years to reap changeOn-going support as well as cash investments neededHonor & respect uniqueness of coalition groups