Diabetes Across the Lifespan
Living a Healthy Lifestyle: The Role of CHWs in Preventing Diabetes through Family Connection
How Culture affects Latino families/vulnerable populations
Hispanic Americans include a diverse group of cultures, each with their traditions and dietary lifestyles, making them more prone to Diabetes. Diabetes is most prevalent among the Latino/Hispanic communities due to poor general health. Poor general health can be associated with the individual’s cultural values, level of education, social support systems, and sedentary behaviors. “Over their lifetime, U.S. adults have a 40 percent chance of developing type 2 diabetes,” the Centers for Disease Control and Prevention (CDC) states. “But if you’re a Hispanic/Latino American adult, your chance is more than 50 percent, and you’re likely to develop it at a younger age.1
Community Health Workers’ interventions addressing diabetes management and prevention.
What is a Community Health Worker?
A Community Health Worker (CHW) is a trusted member of the community she/he serves. CHWs work in both clinical and non-clinical settings and provide referrals to local organizations that assist with health and social services. CHWs meet participants where they are – at home, at work, or out in the community – to better reach participants and meet their unique needs (i.e., food options and culturally related resources). While their primary role is often linking vulnerable populations to the health system, CHW’s may assist in other roles. These can range from cultural mediation, culturally appropriate education, care coordination, case management, systems navigation, coaching and social support, advocacy, capacity building, and outreach. Through these roles, CHWs offer support to patients with diabetes and those at risk of developing diabetes, in a unique culturally appropriate manner.2
Importance of culturally and linguistically appropriate services
CHWs or Promotores(as) de Salud who are mostly bilingual and Latino/a can better connect and communicate with Spanish-speaking communities as they share cultural, linguistic, and economic characteristics with their participants.3 Due to their deep understanding of and trust from the community they serve, CHWs have a unique ability to build strong relationships and effectively address challenges individuals face when managing chronic conditions such as diabetes. Culturally and linguistically appropriate services can improve the quality of health by eliminating miscommunications between health care providers and the community. CHWs take the time to explain diagnosis from a medical provider to participants in their native language and at their level of understanding.
Using a family-centered approach to promote a healthy lifestyle
CHWs are also able to conduct home visits and speak one-on-one with participants on the importance of proper nutrition, physical exercise, and disease management and include the whole family unit for support. CHWs leading diabetes programs encourage parents towards better nutrition options based on their available resources, food options, and exercise options to reduce screen time on digital devices. CHW’s encourage the whole family unit to make small changes in diet and exercise for their overall health. Regular exercise benefits people with diabetes to manage their sugar levels and weight management as well as these benefits listed below.6
- Increased insulin sensitivity (insulin works better)
- Lower blood sugar levels
- Increased energy and endurance throughout the day
- Weight loss with increased muscle tone
- A healthier heart and lower blood pressure
- Better sleep at night
- Stronger bones and a lower risk of osteoporosis
- Better resistance to illness
- Improved cholesterol, heart rate, and blood pressure levels
- Lower stress, anxiety, boredom, frustration, and depression
Overall, CHW interventions have demonstrated success in improving health outcomes among individuals diagnosed with diabetes and support at-risk individuals to prevent the development of the condition.2
Family’s Cultural Challenges and Barriers to Prevent and Manage Diabetes
Diabetes management requires more than following a diet; it requires lifestyle changes to include medication, physical activity, balanced meals, and other factors like stress management and getting enough sleep. Within the Hispanic culture in the U.S, diabetes risk factors include dietary choices usually high in carbohydrates, mostly found in sugars (i.e., soft drinks, pastries, bread, rice, pasta, and tortillas), which are very common in Hispanic foods.6 Dr. De Santis, an endocrinologist with Baptist Health Primary Care, says that being “plump” is considered healthy in Hispanic culture. “We need to show people that the standard they have become used to, especially among Hispanics, is not the correct standard. I encounter this challenge in my day-to-day practice. I have to tell people that what they think is right is actually wrong.”1
COVID-19 Impact on Healthy Habits
The COVID-19 pandemic has changed working and schooling for everyone around the world. Many children have attended or are attending school virtually while some adults are currently working from home, leading to a sedentary lifestyle. One of the significant consequences of the transition to remote learning and working from home during these pandemic times is its impact on health, sleeping habits, and the amount of time children and adults spend on digital devices. In addition to adverse health impacts from altered sleep cycles, increased digital use can affect students’ physical and mental health.4 Children lack physical activity they would receive from physical education classes at school or playing sports. Some public playgrounds remain closed, and children no longer play outside as before pandemic times. There is a fear of contracting COVID-19 in public places such as gyms or parks or where many gather. Living a sedentary lifestyle without exercise can be damaging to health and can lead to obesity and Diabetes. CHWs can provide resources for participants with disabilities or limited mobility to include physical activity into their daily routines. Resources such as information on free exercise programs (i.e. community resource centers, parks, group exercise programs), online videos, and information on household items that can be used to do physical activity at home.
Quote from a CHW
The work we do as CHWs in our communities is important because we take the time to meet with participants in the comfort of their homes or other non-clinical settings to explain the importance of their diabetes management and include the whole family unit for support. We explain the importance of physical activity, medication and offer different options in foods most commonly consumed by our community. We are successful in our work because we are able to communicate with our participants in their preferred language and take the time to explain and answer any questions they may have and can refer them to services accordingly.”
– Selenia Gonzalez, MHP Salud CHW
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This publication is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $753,959.00 with 0 percentage financed with non-governmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS or the U.S. Government. For more information, please visit www.HRSA.gov.