Key considerations for expanding the National Diabetes Prevention Program to Spanish-speaking populations in the state of Georgia Público
Sun, Stephanie (Fall 2019)
Published
Abstract
Hispanic people are disproportionately affected by prediabetes and subsequently diabetes, both nationally and in the state of Georgia. It is estimated that 12.1% of Hispanic people in the United States have been diagnosed with type 2 diabetes, compared to the national average of 9.4%. In Georgia, about 9.1% of Hispanic adults have been diagnosed with diabetes, while an estimated additional 4.5% of Hispanic adults are undiagnosed.
Type 2 diabetes is preventable. The CDC National Diabetes Prevention Program (NDPP) is an evidence-based program that is designed to prevent diabetes among those diagnosed with prediabetes or are at risk for diabetes. The Georgia Department of Public Health (GA DPH) has expressed interest in expanding the NDPP throughout Georgia. Considering that 8% of the Georgia population speaks Spanish as a primary language, there may be an unmet need for diabetes prevention among Spanish-speaking populations. Thus, in order to prevent diabetes amongst those of Hispanic ethnicity in Georgia, GA DPH has an interest in ensuring that Spanish-speaking populations with prediabetes or at high risk of diabetes are connected with appropriate evidence-based programming for prevention.
Developing effective interventions to prevent diabetes among Spanish-speaking individuals in Georgia requires a comprehensive understanding of the scope of the problem at multiple levels of influence. Thus, a gap analysis was conducted using a broad environmental scan of secondary data and interviews with key informants. The primary goals of this gap analysis included: 1) understanding the current landscape of Spanish language NDPP programs in Georgia and assessing the need; and 2) determining facilitating factors and barriers to creating and expanding Spanish-language NDPP programs.
Key findings of this gap analysis include: 1) the causes of increased diabetes risk in Hispanic individuals are multifactorial, 2) there exist knowledge gaps amongst providers and policymakers with respect to diabetes prevention, specifically in Hispanic populations, and 3) tailoring Spanish-language NDPP programs to include culturally relevant materials and partnerships with community resources has been shown to effectively bridge the unmet need in Hispanic communities. Evidence-based recommendations for the GA DPH to expand and create Spanish-language NDPP programs in Georgia, at all levels of influence, are outlined.
Table of Contents
CHAPTER ONE: INTRODUCTION ........................................................................................ 1
Diabetes and Prediabetes ................................................................................................... 1
Diabetes and Prediabetes in the Hispanic/Latinx Community .......................................... 2
CDC National Diabetes Prevention Program (NDPP) ....................................................... 3
Social Ecological Model .................................................................................................... 4
Goal .................................................................................................................................... 4
CHAPTER TWO: LITERATURE REVIEW ........................................................................... 6
Diabetes ............................................................................................................................. 6
Diabetes and Prediabetes Definitions ................................................................................ 7
Epidemiology of Prediabetes ............................................................................................. 7
CDC National Diabetes Prevention Program .................................................................... 9
Diabetes in the Hispanic/Latinx Community .................................................................... 9
Applying the Social Ecological Model to Diabetes within the Hispanic Community .... 10
Conclusion ....................................................................................................................... 17
CHAPTER THREE: METHODS ............................................................................................ 18
Research Design .............................................................................................................. 18
Limitations ....................................................................................................................... 20
CHAPTER FOUR: RESULTS ................................................................................................. 21
Current Distribution of NDPP ......................................................................................... 21
Facilitators to Implementing Spanish-Language NDPP Programs .................................. 22
Barriers to Implementing Spanish-Language NDPP Programs ....................................... 26
CHAPTER FIVE: RECOMMENDATIONS .......................................................................... 30
CHAPTER SIX: PUBLIC HEALTH IMPLICATIONS AND CONCLUSION .................. 34
The Health Toll of Diabetes in Georgia ........................................................................... 34
Potential Impact in Georgia ............................................................................................ 34
Potential Impact Beyond Georgia ................................................................................... 35
Conclusion ....................................................................................................................... 35
REFERENCES ........................................................................................................................... 37
APPENDICES ............................................................................................................................ 45
Appendix A: GA DPH Interview Guide .......................................................................... 45
Appendix B: Policy Brief ................................................................................................. 48
About this Master's Thesis
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