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COLLABORATIVE USMEXICO BORDER DIABETES PREVENTION PROJECT

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Title: COLLABORATIVE USMEXICO BORDER DIABETES PREVENTION PROJECT


1
COLLABORATIVE US-MEXICO BORDER DIABETES
PREVENTION PROJECT
  • Presenters
  • Gloria Beckles
  • Rodolfo Valdez

2
The US-MEXICO BORDER
3
Border Population I
  • About 70 Hispanic
  • High annual growth rates (3.1 for Mexico and
    2.4 for U.S)
  • The rates suggest that the US/MX border
    population will double in about 25 years.

4
Border Population II
  • High poverty levels on both sides of the border
  • A large portion of the Hispanic population is
    uninsured or underinsured
  • Several US border communities are designated
    Medically Underserved Areas

5
Diabetes Mortality Rates for Selected US-Mexico
Border Communities, 1995-1997
6
Diabetes Mortality Rates/100,000 inSelected
US-Mexico Border Counties and Municipalities,
1992-1994 / 1995-1997
7
Description
  • This is a five-year US-Mexico collaborative
    project to determine the prevalence of diabetes
    along the US-Mexico border and to develop
    binational diabetes prevention and control
    programs specific to the needs of the border
    population

8
Partners
  • Pan American Health Organization
  • US-Mexico Border Health Association
  • Centers for Disease Control and Prevention
  • Secretaría de Salud de México
  • State Health Authorities and Diabetes Control
    Programs of
  • Arizona Baja California
  • California Chihuahua
  • New Mexico Coahuila
  • Texas Nuevo León
  • Sonora
  • Tamaulipas
  • Paso del Norte Health Foundation
  • El Paso Diabetes Association
  • Border Health Foundation
  • California Endowment / Project Concern
    International

9
(No Transcript)
10
AMERICAN DIABETES ASSOCIATION
RECOGNITION FOR EXCELLENCE Facility Columbia Med
ical Center Program Name Columbia Diabetes Trea
tment Center Comprehensive Education Outpatient
Program Original recognition date 9/25/98 Cur
rent recognition date 9/25/98
Diabetes Today
El Paso Diabetes Association
11
Funding
  • CDC awarded PAHO 824,000 for project activities
  • Paso del Norte Health Foundation has assigned
    more than 400,000 for the prevalence study in
    its area of influence (Texas).
  • Texas Department of Health contributed 60,000.
  • New Mexico Department of Health contributed
    80,000 to fund the position of US Coordinator.
  • California Endowment awarded the Border Health
    Initiative of Project Concern International
    272,000 to fund project activities in California

12
Management
  • PAHO coordinates activities supported by
  • Executive Committee
  • Scientific Committee
  • Workgroups
  • Intervention Advisory Committee
  • Workgroups
  • CDC and SSM advisors

13
Rationale
  • Diabetes is common among people of Mexican
    ancestry.
  • The prevalence of diabetes along the US/MX border
    is unknown.
  • Health Departments in the US border states are
    concerned that the information from the statewide
    BRFSS may not be applicable to the border
    population.

14
Purpose
  • The purpose of the project is two-fold
  • Assess the burden of diabetes and related factors
    in the border population.
  • Provide information for diabetes program
    development and implementation.

15
Objectives
  • Phase I
  • Prevalence of diabetes
  • Prevalence of lifestyle factors
  • Access to/Quality of health care
  • Data analysis
  • Literature review of community interventions
  • Phase II
  • Intervention

16
Sample I
  • Persons aged 18 years or older
  • Counties contiguous with US/MX border
  • Residents of census tracts in counties with
    cities of 50,000 people or more
  • Residents of census tracts in municipalities with
    2,500 people or more

17
Sample II US
  • Strata
  • Arizona
  • California-San Diego County
  • California-Imperial County
  • New Mexico
  • Texas-El Paso County
  • Texas-Other counties
  • Within each stratum two ethnic groups
    (Hispanic, Non-Hispanic) will be selected

18
Sample III Mexico
  • Strata
  • Baja California
  • Sonora
  • Chihuahua
  • Coahuila
  • Nuevo León
  • Tamaulipas

19
Sample size US
20
Sample size Mexico / Total
21
Data Collection
  • Questionnaire (Demographics, behavioral risk
    factors, access to health care, quality of care)
  • Venipuncture (FPG, HbA1c)
  • BP measurement (SBP, DBP, HBP)
  • Anthropometry (Ht, Wt, WC)

22
Prevalence estimates
  • Diabetes prevalence estimates for
  • US-México Border region
  • US Border population
  • Hispanic
  • Non-Hispanic
  • México Border population
  • Border population of each state

23
Current Status I
  • Household questionnaires and operation manuals
    have been developed in English and Spanish
  • A field test has been completed in El Paso and
    Ciudad Juárez area
  • A binational sample design has been developed
  • Communities to be surveyed have been selected
  • Communication plan is being developed

24
Current Status II
  • IRB approvals have been obtained from the US and
    Mexico
  • OMB approval has been obtained (US)
  • Laboratories for blood analyses have been
    identified
  • Inventory of interventions has been created
  • The survey is about to start in the Texas-New
    Mexico-Chihuahua and California-Baja California
    regions

25
The US-MEXICO BORDER
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