Abstract
A project in a Texas border community setting, Prevention Organized against Diabetes and Dialysis with Education and Resources (POD2ER), 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. 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. 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. 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. 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.
Highlights
People living in the border region of Texas closest to the Gulf of Mexico, known as 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
The project took on a complex set of activities, as reflected by the project name, POD2ER, Prevention Organized against Diabetes and Dialysis with Education and Resources in English and Preven ción Organizada contra la Diabetes y Diálisis con Educación y Recursos in Spanish
Prevention Organized against Diabetes and Dialysis with Edu cation and Resources incorporated the following elements supported by the literature: a promotora, community-based diabetes screenings, a culturally tailored program, and a project site in an environment where the priority population felt comfortable
Summary
People living in the border region of Texas closest to the Gulf of Mexico, known as 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. Diabetes hospitalization rates are among the highest in Texas (20.0 per 10,000, State Health Services Region 11; compared with 17.1 statewide) [5]. Research shows that interventions delivered to Hispanic border residents by community health workers result in significant improvements in glycemic control [10]. The work of community clinics and community centers in the LRGV routinely involves community health workers, called promotores de salud (promotoras for those who are women). They provide a crucial element of translational services between Spanish and English and between complex medical information and explanations comprehensible to people with low health literacy. A promotora played a key role in the development of this intervention
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
