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Pilot of a Diabetes Primary Prevention Program in a Hard-to-Reach, Low-Income, Immigrant Hispanic Population

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Abstract

An immigrant Hispanic population in the Texas-Mexico border region urgently requested assistance with diabetes. The project team implemented an exploratory pilot intervention to prevent type 2 diabetes in the general population through enhanced nutrition and physical activity. Social networks in low-income rural areas (colonias) participated in an adaptation of the Diabetes Empowerment Education Program. The program had a pre-post-test design with a comparison group. The intervention had a small but significant effect in lowering body mass index, the biological outcome variable. The process evaluation shows that the participants valued the pilot project and found it culturally and economically appropriate. This program was the first primary prevention program in diabetes to address a general population successfully. The study shows that low-income, rural Mexican American families will take ownership of a program that is participatory and tailored to their culture and economic situation.

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Acknowledgments

This project, Early Prevention of Diabetes & Improved Access to Health Care, Phase 2, received funding from the Office of Border Health, Texas Department of State Health Services (Contract No. 2007-022910, Pr. Att. No. 001, P.O. 330130). We thank DSHS staff for their advice and support: Edith de Lafuente, Lupita Guerrero, Kassie Rogers, Diana Garcia, Kathie Martinez, and Luby Garza. We also thank Mary Cruz Polanco, Eric Cervantes, Lucy Cevallos-Felix, and Genoveva Martinez of Migrant Health Promotion. We are grateful to the following for sharing their questionnaires: Secretaria de Salud, Subsecretaria de Prevención y Promoción de la Salud, Dirección General de Epidemiología y Comisión de Salud Fronteriza México-Estados Unidos; Dr. Nelda Mier (co-author), and Dr. Belinda Reininger. We additionally thank Dr. Dan Reyna of the U.S.-Mexico Border Health Commission for his encouragement and the people of the colonias for their participation.

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Authors and Affiliations

  1. School of Rural Public Health-McAllen Campus, Texas A&M Health Science Center, McAllen, TX, USA

    Ann V. Millard & Nelda Mier

  2. Department of Psychology and Anthropology, The Univerity of Texas-Pan American, 1201 West University Drive, Edinburg, TX, 78539, USA

    Margaret A. Graham

  3. Department of Mathematics, The University of Texas-Pan American, Edinburg, TX, USA

    Xiaohui Wang

  4. International Valley Health Institute, Edinburg, TX, USA

    Esmeralda R. Sánchez & Isidore Flores

  5. Texas Department of State Health Services, Office of Border Health, Harlingen, TX, USA

    Marta Elizondo-Fournier

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  1. Ann V. Millard
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Correspondence to Margaret A. Graham.

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Millard, A.V., Graham, M.A., Wang, X. et al. Pilot of a Diabetes Primary Prevention Program in a Hard-to-Reach, Low-Income, Immigrant Hispanic Population. J Immigrant Minority Health 13, 906–913 (2011). https://doi.org/10.1007/s10903-010-9412-y

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