The US Mexico Border Diabetes Prevention and Control Project

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The US- Mexico Border Diabetes Prevention and
Control Project

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Rosalba Ruiz-Holguin MD MPH
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Trends in diabetes prevalence U.S. 1958-2004

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NHIS for 1980-2004
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USMXBDPCP

• GOAL
• To reduce the impact of diabetes in United
  States-Mexico border residents, through
  participation, shared leadership

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Sampling
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Sampling scheme

• A multistage, cluster sample design
• Survey was conducted in 44 counties and
  municipalities
• A 65 question survey was administered
• 4,020 participants

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California Imperial, San Diego Baja California
Tecate, Tijuana, Mexicali, Algodones Arizo
na Yuma, Pima, Cochise, Santa Cruz Sonora Agua
Prieta, Altar, Caborca, Cananea, Luis B.
Sánchez, Naco, Nogales, Puerto Peñasco, SLRC,
Sonoita Nuevo Mexico Doña Ana, Luna, Hidalgo

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Chihuahua Juárez, Guadalupe,Praxedis,
Ascensión, Ojinaga Texas El Paso,
Presidio, Hidalgo, Cameron, Webb, Maverick,
Valverde Coahuila Piedras Negras, Nava,
Acuña Nuevo Leon Anahuac Tamaulipas Matamoros
, Camargo, Miguel Aleman, Nuevo Laredo,
Reynosa

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Local site structure

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Survey components

• Questionnaire
• Anthropometric measurements
• Blood Pressure reading
• Laboratory

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Project Challenges

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• Limited resources
• High turnover rate among staff
• Coordination and communication in a bi-national
  setting
• Timelines difficult to meet

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Project strengthens

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• Bi national collaboration
• More than 130 institutions involved in the
  project
• Development of culturally appropriate materials
• Development of educational and technical programs

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Method and statistical package used for variance
estimation

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• The Taylor method was used for sampling variance
  estimation of all variables
• Design effects were included for calculation of
  all confidence intervals
• SAS/SESUDAAN statistical package was used to
  accommodate the complex survey design, and to
  allow for estimation of means, proportions,
  totals, ratios, and multivariate regression
  coefficients

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Results
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Distribution of US-MX Border Survey Population by
Age 2000-01
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Distribution of US-Mx Border Survey Population by
Level of Education 2000-01
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Diabetes Prevalence in The US-Mx Border Region,
U.S.A. and Mexico 2000
Adjusted US 2000 Population
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Diabetes Prevalence in The US-Mx Border Region,
U.S.A. and Mexico 2000
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Prevalence of Diabetes in The US-Mx Border Region
Among Women by Age 2000-01
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Prevalence of Diabetes in The US-Mx Border Region
Among Men by Age 2000-01
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Prevalence of Undiagnosed Diabetes Among The
US-Mx Border Region 2000-01
Adjusted US 2000 Population
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Prevalence of Diabetes and Undiagnosed Diabetes
in The MX Border Region by State 2000-01
Adjusted US 2000 population
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Prevalence of Diabetes and Undiagnosed Diabetes
in The U.S. Border Region by State 2000-01
Adjusted US 2000 Population
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Prevalence of Being Unaware of Diabetes Among
US-Mx Border Residents 2000-01
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Prevalence of Being Unaware of Diabetes Among The
U.S. Border Residents by State 2000-01
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Prevalence of Being Unaware of Diabetes Among Mx
Border Residents by State 2000-01
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Risk Factors

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Prevalence of Pre-diabetes in The US-Mx Border
Region 2000-01
Adjusted US 2000 Population
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Prevalence of Pre-Diabetes in The US-Mx Border
Region by Age 2000-01
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Gestational Diabetes Prevalence US-Mx Border
Region 2000-01
Adjusted US 2000 Population
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Prevalence of Family History of Diabetes in The
US-Mx Border Region 2000-01
Adjusted 2000 US population
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Prevalence of Overweight (BMI 25-29) in The
US-Mx Border Region 2000-01
Adjusted 2000 US population
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Prevalence of Overweight (BMI 25-29) in The
US-Mx Border Region by Age 2000-01
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Prevalence of Obesity (BMI 30)in The US-Mx
Border Region 2000-01
Adjusted 2000 US population
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Prevalence of Obesity (BMI 30) in The US-Mx
Border Region by Age 2000-01
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Prevalence of Obesity (BMI 30) in The Mexico
Border Region by Age 2000-01
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Prevalence of Obesity (BMI 30) in The U.S.
Border Region by Age 2000-01
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Prevalence of Overweight and Obesity Among
Persons with Diabetes in The U.S. Border Region
by State 2000-01
Adjusted US 2000 population
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Prevalence of Overweight and Obesity Among
Persons with Diabetes in The Mexico Border Region
by State 2000-01
Adjusted US 2000 Population
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Prevalence of Hypertension (SBP 140 DBP 90)
in The US-Mx Border Region 2000-01
Adjusted US 2000 Population
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Prevalence of Hypertension (SBP 140 DBP 90)
in The US-Mx Border Region by Age 2000-01
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Behaviors Knowledge and Access to Care

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Prevalence of Physical ActivityUS-Mx Border
Region 2000-01
Adjusted US 2000 Population
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Numbers of Days per Week Practicing Physical
Activity US-Mx Border Region 2000-01
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Minutes per Session Practicing Physical Activity
US-Mx Border Region 2000-01
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Prevalence of Physical Activity US-Mx Border
Region by Age 2000-01
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Prevalence of Persons with Sedentary Jobs US-Mx
Border Region by Age 2000-01
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Prevalence of Smoking US-Mx Border Region
2000-01
Adjusted US 2000 Population
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Prevalence of Smoking Among Persons with Diabetes
US-Mx Border Region by Age 2000-01
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Prevalence of Smoking Among Persons with Diabetes
US-Mx Border Region by Gender 2000-01
Adjusted US 2000 population
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Number of Days per Month People Consume Alcohol
US-Mx Border Region 2000-01
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Percent of People Reporting Have Heard/read About
Diabetes Prevention US-Mx Border Region 2000-01
Adjusted US 2000 population
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Preventive Health Practices Reported by Persons
with Diabetes US-Mx Border Region 2000-01
Adjusted US 2000 population
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Percent of People with Diabetes Receiving Health
Care Services (Last 12 mo) US-Mx Border Region
2000-01
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Percent of People with Diabetes Performing
Self-Examination of Blood Glucose (Last 12 mo)
US-Mx Border Region 2000-01
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Percent of People with Diabetes Receiving Eye
Exam (Last 12 mo) US-Mx Border Region 2000-01
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Percent of People Receiving Foot Exam (Last 12
mo) US-Mx Border Region with Diabetes 2000-01
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Percent of People with Diabetes Receiving Oral
Medication or Insulin US-Mx Border Region 2000-01
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Percent of People With/Without Diabetes Who Have
Health Insurance The US-Mx Border Region 2000-01
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Recommendations
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Thank You