Stronghold Diabetes

Management Natasha AttawallaDaniel GedeonJulia OrchinikLaTiana RidgellBingqing Zhang

Diabetes Prevalence• Between 1980 and 2011, the number of

Americans diagnosed almost quadrupled (from 5.6 million to 20.9 million) (Centers for Disease Control and Prevention [CDC], 2013)

• 9.3% of Americans living with diabetes (CDC, 2014)

• More prevalent in American Indians (15.9%) and African Americans (13.2%) (American Diabetes Association [ADA], 2015) Figure 1Number (in Millions) of Civilian, Noninstitutionalized Persons with

Diagnosed Diabetes, United States, 1980–2011 (CDC, National Center for Chronic Disease Prevention and Health Promotion, 2013)

The Burden of Diabetes in the U.S.

Health Complications

• 7th leading cause of death in the U.S.

• Increases Risk• Diseases

• hypertension• kidney disease

• Stroke• Heart attacks• Lower Extremity Amputation

Economic Burden

• Cost of Diabetes • $218 Billion in 2007

• $245 Billion in 2012

Includes Direct Medical Costs ($176 billion)

• Mostly paid by Government insurance

• Also includes Indirect Cost ($69 billion)

• Loss of Productivity

• AbsenteeismBeckles and Chou, 2013

Philadelphia and the role of diabetes

● Philadelphia has highest prevalence of diabetes out of any of the 11 largest cities in the U.S.● 16% of adult residents diagnosed with diabetes● Onset of diabetes more prevalent in adults aged 45-64, but is becoming increasingly common in youth under the age of 20● African Americans had a significantly higher diabetes hospitalization rates than any other race/ethnicity between 2000 and 2009.

(Philadelphia Department of Public Health, 2015)

Diabetes in PhiladelphiaChristian Stronghold Church

West Park

(Philadelphia Department of Public Health, 2015)

Health Belief Model

Individual-based framework(Rosenstock, 1988)

Perceived susceptibility

Perceived Severity

Perceived Benefits

Perceived Barriers

Self-Efficacy

Cues to Action

Stronghold Diabetes Management Program

Mission: SDMP will offer each cohort (3 per year) with intense training and support to better control participants diabetes management

Inclusion: Newly diagnosed within 5 years; 40 years and older congregation member

Culmination Celebration

ExerciseRevitalize

ApplicationStation

MedicationExplanation

Nutrition Expedition

Education Sensation

Navigation Buddy

Behavioral Strategy

•Diabetes peer support intervention improves glycemic control (Piette, Resnicow, Choi, & Heisler, 2013)

•Buddies will discuss in class each week about their goal strategies

•The Community Guide’s systematic review of community-based programs revealed strong evidence for program that incorporate setting goals and building social support (Task Force on Community Preventive, 2002)

Stronghold Support Team

Total 2-Year Budget: $202,200

Weekly Meals: $300 x 6 weeks x 3 cohorts/per yearStaff:

•Lead Instructor- $15,000/per year•Full-time Organizer- $50,000/per year•Support Group Leader- $15,000/ per year•Fitness Instructor- $7,500/ per year•Youth Interns (4)- $1,500 per intern/ per year•Child Care Services (2)- $3600 per caregiver/ per year

Expertise Support

Training Facilitation

Human Rights Framework

International Covenant on Economic, Social and Cultural Rights (ICESCR)• Article 12: The right to the highest attainable standard of health• Article 13: The right to education

(United Nations Human Rights, ICESCR, 1976)

International Covenant on Civil and Political Rights (ICCPR)• Article 19: The right to information

(United Nations Human Rights, ICCPR, 1976)

Universal Declaration of Human Rights (UDHR)• Article 25(1): “Everyone has the right to a standard of living adequate for the health

and well-being of himself and his family…”(United Nations, 1948)

Cultural and Linguistic Competence

Readable

Feasible

Practical

Sustainabilities

Feedback• Participants will provide survey feedback

following the program• Provide Platform for past participants to share

experiences

Leadership capacity• Youth Interns/Social Media • Program Organizer and Support group leader

Local partnerships• Local food markets• Gangster Vegan Organics

ReferencesAmerican Diabetes Association, 2015. Statistics about diabetes [Image file.] Retrieved from http://www.diabetes.org/diabetes-

basics/statistics/Beckles, G. L.,Chou C. F.,. (2013) Diabetes- United States, 2006 and 2010. (2013). CDC Health Disparities and Inequalities Report —

United States, 2013. 62(3): 99-104. retrieved from: http://www.cdc.gov/mmwr/pdf/other/su6203.pdfBoltri, J. M., Davis-Smith, M., Zayas, L. E., Shellenberger, S., Seale, J. P., Blalock, T. W., & Mbadinuju, A. (2006). Developing a Church-

Based Diabetes Prevention Program With African Americans: Focus Group Findings. The Diabetes Educator, 32(6), 901-909. doi:10.1177/0145721706295010

Bopp, M., Peterson, J. A., & Webb, B. L. (2012). A Comprehensive Review of Faith-Based Physical Activity Interventions. American Journal of Lifestyle Medicine, 6(6), 460-478. doi:10.1177/1559827612439285

Centers for Disease Control and Prevention, 2013. Number (in millions) of civilian, noninstitutionalized persons with diagnosed diabetes, United States, 1980-2011. Retrieved from http://www.cdc.gov/diabetes/statistics/prev/national/figpersons.htm

Centers for Disease Control and Prevention, 2014. National diabetes statistics report. Retrieved fromhttp://www.cdc.gov/diabetes/data/statistics/2014statisticsreport.html

Kahn, E., Ramsey, L., Brownson, R., Heath, G., Howze, E., Powell, K.. . Task Force Commun Prevent Serv. (2002). The effectiveness of interventions to increase physical activity - A systematic review. American Journal of Preventive Medicine, 22(4), 73-108.

Pennsylvania Department of Health. (2011). Chronic Disease in Pennsylvania. Retrieved from http://www.health.pa.gov/migration/Documents/ChronicDiseaseBurdenReport.pdf

Philadelphia Department of Public Health. (2015). Community health assessment. Retrieved from http://www.phila.gov/health/pdfs/CHAreport_52114_final.pdf

Task Force on Community Preventive, S. (2002). Recommendations to increase physical activity in communities. American Journal of Preventive Medicine, 22(4, Supplement 1), 67-72. doi:http://dx.doi.org/10.1016/S0749-3797(02)00433-6

Rosenstock, I. M., Strecher, V. J., & Becker, M. H. (1988). Social Learning Theory and the Health Belief Model. Health Education & Behavior, 15(2), 175–183. http://doi.org/10.1177/109019818801500203

United Nations, 1948. Universal declaration of human rights. Retrieved from http://www.ohchr.org/EN/UDHR/Documents/UDHR_Translations/eng.pdf

United Nations Human Rights, 1976. International covenant on civil and political rights. Retrieved from http://www.ohchr.org/en/professionalinterest/pages/ccpr.aspx

United Nations Human Rights, 1976. International covenant on economic, social and cultural rights. Retrieved from http://www.ohchr.org/EN/ProfessionalInterest/Pages/CESCR.aspx