Community Influences on Diabetes

Knowledge & Lifestyle of Individuals &

Families

Sharon A. Denham, PhD, RN, CNE

Professor, Houston J. & Florence A. Doswell Endowed Chair in Nursing for Teaching
Excellence
Texas Woman's University, College of Nursing

OBJECTIVES

Describe a funded project aimed at enhancing

sustainable healthy lifestyles for families where persons
are diagnosed with type 2 diabetes.
Discuss ways the Family Health Model (Denham, 2003)
was used to plan family & implement community
interventions that affected lifestyle individual & family
behaviors to manage & prevent type 2 diabetes.
Identify outcomes of project efforts.

VULNERABLE POPULATION
GOALS
(CDC, 2010 - 2013)

Developed community coalitions in four states (KY,

MS, OH, VA) and 11 counties (3 regions) in the
Appalachian region

Strengthen diabetes knowledge in all counties

Map county assets & develop strategic plans

Address type 2 diabetes prevention

Create sustainable activities to manage & prevent type

2 diabetes

APPALACHIA

FAMILY HEALTH MODEL

(DENHAM, 2003)

Contextual perspectives - Family

household/community

Functional perspectives - Supportive

relationships
Structural perspectives - Family health
routines

http://www.diabetesfamily.net/family/familyhealth-model/

SOCIO- ECOLOGICAL
PERSPECTIVE

Family & community are connected

11 County Town Meetings - Inform about the type 2
diabetes problem (individual, family, county, &
Appalachia)
Train- the - Trainer model - Local people teaching &
supporting one another

VOLUNTEERS DIABETES
COALITIONS

Listen

Build Trust

Show Up - Be
dependable

PROJECT YEAR #1

Coalition formation & development activities - Small

amounts of money, multiple forms of support,
genuine care
Community education about the burden of type 2
diabetes
Living with diabetes in your family & community - 100
interviews conducted & filmed
Lessons learned: Invest time, build a positive
community reputation, & listen.

PROJECT YEAR #2 & #3

Built upon prior efforts

Films (4) created & distributed in communities

Music CD created & distributed in communities

OTHER ACTIVITIES - YEAR #2 &

#3

Healthy for GOoD

Walking Trails

Turtle Challenge

Kids Bucks

CHURCH - BASED
PROGRAMS

Gain support of local ministers in each county

Provided two regional educational workshops
annually
Outcomes: Community involvement,
community gardens, church suppers, weight
loss, walking clubs, etc.
Increased knowledge of type 2 diabetes risks,
management, and prevention

YEAR #3 ACTIVITIES

Built networks that involved health care providers

Developed 4 week county diabetes education programs
- supported by local health care services

PROJECT OUTCOMES

Established supportive community networks

outside traditional health care services.
Community driven - Bottom up approach to the
problem
Result of strong (a) individual determination, (b)
partnerships, (c) shared individual & community
relationships, and (d) shared vision.
Involved families

LESSONS LEARNED

Start with a dedicated/committed group

Value in networking & collaborating with others in the
community

Need minimum of 3 to 5 years to reap change

On-going support as well as cash investments needed

Honor & respect uniqueness of coalition groups