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Every Little Step Counts

An Evidence-Based Practice

Description

"Every Little Step Counts" was an effort to create a culturally appropriate healthy lifestyle education program for Latino adolescents at highest risk for Type 2 Diabetes in the Phoenix, Arizona area. Participants were referred to the clinic by local school nurses. They were required to have a BMI in the 95th percentile or higher and also had to meet other criteria based on the American Diabetes Association's screening recommendations for Type 2 diabetes in youth. Before enrolling in the program, laboratory testing for insulin resistance and cholesterol levels was performed. The initial appointment included a discussion of medical history and a physical exam.

Following the exam, children and their parents attended culturally appropriate healthy lifestyle education classes that dealt with issues such as the connection between weight, health, nutrition, and diabetes; roles and responsibilities of the children and their families around communication and health; education about and encouragement of physical activity; self-esteem and self-efficacy for making healthy decisions; and developing an individual healthy behavior plan and strategies for behavior change. Approximately three months after the end of the classes, participants returned for a one-on-one appointment with a dietician where challenges in maintaining behavior change were discussed. Adolescents continued with follow-up sessions on problem solving, dietary adjustments, and other counseling.

Goal / Mission

To create a culturally appropriate healthy lifestyle educational program for Latino adolescents at highest risk for Type 2 Diabetes.

Impact

The promising findings of this program suggest that a community-based diabetes prevention program for obese Latino youth is a feasible strategy for improving health in this high-risk population.

Results / Accomplishments

Of the 102 initial enrollees, 60.6% had elevated fasting insulin levels, 9.4% had impaired fasting glucose, 32.1% had high triglyceride levels, 39.4% had high total cholesterol, 68.6% had low HDL cholesterol, and 43.0% had high LDL cholesterol. The 50 youth who returned for post-intervention labs reduced BMI by 3.8% (p < 0.01) over an average of 13 months. They also reduced total cholesterol by 5.4% (p < 0.01) and LDL cholesterol by 8.6% (p < 0.01), and increased HDL cholesterol by 9.3% (p < 0.01). There was a decrease for fasting insulin by 24.0% (p < 0.05). There was no significant difference in the risk factors measured at initial enrollment for youth who completed follow up testing and those who did not complete follow up testing.

About this Promising Practice

Organization(s)
Arizona State University, Southwest Interdisciplinary Research Center (Center for Health Promotion and Disease Prevention)
Primary Contact
Gabriel Shaibi, PhD
Arizona State University
Center for Health Promotion and Disease Prevention
500 N. 3rd Street
Phoenix, AZ 85004
(602) 496-2283
gabriel.shaibi@asu.edu
http://sirc.asu.edu/
Topics
Health / Physical Activity
Health / Adolescent Health
Health / Diabetes
Organization(s)
Arizona State University, Southwest Interdisciplinary Research Center (Center for Health Promotion and Disease Prevention)
Source
Journal of Primary Care and Community Health
Date of publication
9/30/2010
Date of implementation
2005
Geographic Type
Urban
Location
Phoenix, AZ
For more details
Target Audience
Children, Teens, Racial/Ethnic Minorities
Additional Audience
Latino
Michigan Health Improvement Alliance