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Calo WA, Aumiller B, Murray A, Crawford L, Bermudez M, Weaver L, Henao MP, Gray NM, DeLoatch V, Rivera-Collazo D, Gomez J, Kraschnewski JL. Expanding opportunities for chronic disease prevention for Hispanics: the Better Together REACH program in Pennsylvania. Front Public Health 2023; 11:1134044. [PMID: 37408745 PMCID: PMC10318166 DOI: 10.3389/fpubh.2023.1134044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 05/23/2023] [Indexed: 07/07/2023] Open
Abstract
Background Hispanics in Lebanon and Reading, Pennsylvania, experience high levels of socioeconomic and health disparities in risk factors for chronic disease. In 2018, our community-academic coalition "Better Together" received a Racial and Ethnic Approaches to Community Health (REACH) award to improve healthy lifestyles. This report describes our work-in-progress and lessons learned to date from our REACH-supported initiatives in Lebanon and Reading. Methods For the past 4 years, our coalition has leveraged strong community collaborations to implement and evaluate culturally-tailored practice- and evidence-based activities aimed at increasing physical activity, healthy nutrition, and community-clinical linkages. This community case report summarizes the context where our overall program was implemented, including the priority population, target geographical area, socioeconomic and health disparities data, community-academic coalition, conceptual model, and details the progress of the Better Together initiative in the two communities impacted. Results To improve physical activity, we are: (1) creating new and enhancing existing trails connecting everyday destinations through city redesigning and master planning, (2) promoting outdoor physical activity, (3) increasing awareness of community resources for chronic disease prevention, and (4) supporting access to bikes for youth and families. To improve nutrition, we are: (1) expanding access to locally-grown fresh fruit and vegetables in community and clinical settings, through the Farmers Market Nutrition Program to beneficiaries of the Women, Infants, and Children (WIC) program and the Veggie Rx to patients who are at risk for or have diabetes, and (2) providing bilingual breastfeeding education. To enhance community-clinical linkages, we are training bilingual community health workers to connect at-risk individuals with diabetes prevention programs. Conclusions Intervening in areas facing high chronic disease health disparities leads us to develop a community-collaborative blueprint that can be replicated across Hispanic communities in Pennsylvania and the United States.
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Affiliation(s)
- William A. Calo
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States
| | - Betsy Aumiller
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States
| | - Andrea Murray
- Department of Medicine, Penn State College of Medicine, Hershey, PA, United States
| | - Laurie Crawford
- Department of Medicine, Penn State College of Medicine, Hershey, PA, United States
| | - Madeline Bermudez
- Department of Medicine, Penn State College of Medicine, Hershey, PA, United States
| | - Lisa Weaver
- Penn State Health St. Joseph, Reading, PA, United States
- Penn State Berks, Reading, PA, United States
| | - Maria Paula Henao
- Department of Medicine, Penn State College of Medicine, Hershey, PA, United States
| | | | - Vicki DeLoatch
- Lebanon Family Health Services, Lebanon, PA, United States
| | | | - Janelle Gomez
- Department of Medicine, Penn State College of Medicine, Hershey, PA, United States
| | - Jennifer L. Kraschnewski
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States
- Department of Medicine, Penn State College of Medicine, Hershey, PA, United States
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Agbaria N, Nubani-Husseini M, Barakat RA, Leiter E, Greenberg KL, Karjawally M, Keidar O, Donchin M, Zwas DR. Two-Phase Evaluation of a Community-Based Lifestyle Intervention for Palestinian Women in East Jerusalem: A Quasi-Experimental Study Followed by Dissemination. Int J Environ Res Public Health 2020; 17:E9184. [PMID: 33316905 PMCID: PMC7763328 DOI: 10.3390/ijerph17249184] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 11/25/2020] [Accepted: 12/02/2020] [Indexed: 01/06/2023]
Abstract
Palestinian-Arab women are at increased risk of cardiovascular disease due to high prevalence of diabetes and other risk factors. The current study investigates the effectiveness of an intensive group-based intervention on lifestyle habits that can prevent diabetes and cardiovascular disease. To that end, we conducted a group-based intervention based on the diabetes prevention program in two consecutive phases. The first phase consisted of a quasi-experimental study and the second phase included community-wide dissemination, with a 6-month follow-up. Findings from the quasi-experiment indicate increased consumption of fruit, vegetables and whole grains, weight reduction (-2.21 kg, p < 0.01), and a significant increase in the average daily steps in the intervention group (from 4456 to 6404). Findings from the dissemination indicate that average daily vegetables consumption increased from 1.76 to 2.32/day as did physical activity and average daily steps (from 4804 to 5827). There was a significant reduction in blood pressure, total cholesterol and LDL. These gains were sustained over 6 months following the intervention. This community-based, culturally adapted, health-promotion intervention led to improved nutrition and physical activity which were maintained after 6 months. Collaboration with community centers and local community partners created an effective channel for dissemination of the program to pre-clinical individuals.
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Affiliation(s)
- Nisreen Agbaria
- Linda Joy Pollin Cardiovascular Wellness Center for Women, Division of Cardiology, Hadassah University Medical Center, Jerusalem 91120, Israel; (M.N.-H.); (E.L.); (K.L.G.); (M.K.); (D.R.Z.)
| | - Maha Nubani-Husseini
- Linda Joy Pollin Cardiovascular Wellness Center for Women, Division of Cardiology, Hadassah University Medical Center, Jerusalem 91120, Israel; (M.N.-H.); (E.L.); (K.L.G.); (M.K.); (D.R.Z.)
| | - Raghda A. Barakat
- The Nutrition Division, The Israeli Ministry of Health, Jerusalem 91011002, Israel;
| | - Elisheva Leiter
- Linda Joy Pollin Cardiovascular Wellness Center for Women, Division of Cardiology, Hadassah University Medical Center, Jerusalem 91120, Israel; (M.N.-H.); (E.L.); (K.L.G.); (M.K.); (D.R.Z.)
| | - Keren L. Greenberg
- Linda Joy Pollin Cardiovascular Wellness Center for Women, Division of Cardiology, Hadassah University Medical Center, Jerusalem 91120, Israel; (M.N.-H.); (E.L.); (K.L.G.); (M.K.); (D.R.Z.)
| | - Mayada Karjawally
- Linda Joy Pollin Cardiovascular Wellness Center for Women, Division of Cardiology, Hadassah University Medical Center, Jerusalem 91120, Israel; (M.N.-H.); (E.L.); (K.L.G.); (M.K.); (D.R.Z.)
| | - Osnat Keidar
- Braun School of Public Health and Community Medicine, The Hebrew University of Jerusalem-Hadassah, Jerusalem 91120, Israel; (O.K.); (M.D.)
| | - Milka Donchin
- Braun School of Public Health and Community Medicine, The Hebrew University of Jerusalem-Hadassah, Jerusalem 91120, Israel; (O.K.); (M.D.)
| | - Donna R. Zwas
- Linda Joy Pollin Cardiovascular Wellness Center for Women, Division of Cardiology, Hadassah University Medical Center, Jerusalem 91120, Israel; (M.N.-H.); (E.L.); (K.L.G.); (M.K.); (D.R.Z.)
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