Safiat Amuwo College of Nursing UIC Great Cities Neighborhood Initiative * SROP 2007

1. Comparative analysis of participants lost to follow-up in the Chicago Lawndale REACH 2010 intervention Reduce disparities in Diabetes and Cardiovascular disease Safiat Amuwo College of Nursing UIC Great Cities Neighborhood Initiative * SROP 2007 Faculty Mentor Dr. Cynthia Barnes-Boyd

2. Literature Review Summary of Background information • Racial disparities in healthcare • Onset of Type 2 diabetes in relation to obesity and lack of physical activity • Prevalence of Type 2 diabetes is higher in low socioeconomic areas • Institutional racism based upon race and ethnicity • Lower expectations for patients in disadvantaged social positions

3. What is REACH 2010 • Reach 2010 is a national intervention to address health disparities in 40 communities across the United States. • REACH 2010 is a Center for Disease Control, demonstration project that supports grants in these communities. • The Grantee in Chicago is the Chicago Department of Public Health • The UIC Neighborhoods Initiative was selected as the evaluator of the project

4. REACH 2010 Funding (National) 4 2 3 2 2 2 REACH Funded Communities There are 3 REACH 2010 projects in Chicago

5. Populations African Americans American Indians Alaska Natives Asian Americans Pacific Islanders Hispanics/Latinos Areas of interest HIV/AIDS Breast and Cervical cancer and management screening Cardiovascular disease (CDV) Diabetes Mellitus Immunizations Infant Mortality Targeted populations and Areas of Interest: REACH 2010 (national)

6. North and South Lawndale

7. North Lawndale Total population 41, 768 95 % African American Unemployment rate 26% Below poverty level 45% Median household income 18, 342 South Lawndale Total population 91, 071 83 % Latino Unemployment rate 12% Below poverty level 27% Median household income 32,320 Community Demographics

8. Area of Interest Screen for diabetes and Cardiovascular (CDV) risk factors and provide awareness to risk reduction strategies in Chicago Lawndale communities Targeted population African American and Latino REACH 2010 (Chicago Lawndale)

9. Diabetes is an internal disease in which the body does not produce or properly use insulin. What is Diabetes? What is Cardiovascular Disease? Class of diseases that involve the heart, arteries, and/or veins.

10. My Research primarily focuses on Subjects with Type 2 Diabetes Mellitus within North and South Lawndale Communities

11. Project Problem Statement • There is a wide and growing gap in the incidence of diabetes and CVD between African Americans and Latinos when compared to Caucasians.

12. The Intervention Promote risk reduction and disease control behaviors among persons with type 2 diabetes and/or high normal blood pressure through a family-centered Case management system • Over 500 residents received intensive case management services for one year through an established network of community providers

13. Intervention • Participants received case management, education and medical care for 1 year • An objective interviewer conducted a survey at • Time of recruitment • 6 and 12 months

14. My Problem Focus • Not all participants completed the case management program • Many were lost to follow up for various unknown reasons

15. Research Question • How will participants who left the REACH 2010 intervention program differ from those who remained in the program? • Why did these participants leave the program before the 12 month completion marker?

16. Hypothesis Participants who left the REACH 2010 intervention program before the 12 month period, differ from those who remained in the project.

17. Methodology • A Sample was selected from the population of participants that did not complete the intervention • 45 participants were randomly selected • A modified telephone survey was developed

18. Methodology • Survey • Assess health status and health confidence • Explored reasons for leaving the program • Data will be analyzed using simple descriptive statistics to compare the samples

19. Assumptions • Participants have telephones and the numbers provided are valid • Participants use the case manager’s advice. • Participants supply accurate information to case manager • Case managers are recording appropriate information about their participants. • Participants fully understand the information that their case manager provides.

20. Limitations This information is place specific and cannot be generalized to other urban communities.

21. Results

22. Results • The results of this project are still being analyzed in order to record and document the best findings that this study can provide. This project is still within its early states due to this alternative method and more work needs to be done to provide an accurate evaluation.

23. Conclusion • This study shows that there is much difficulty to remain in contact with participants taking place in a longitudinal study. • Comparison will be drawn upon 30 participants who left the program based upon demographics. • This project is still being analyzed and more work needs to be done to provide an accurate evaluation. However, by not being able to contact these participants we can speculate that

24. Conclusion • Some participants who left the program did not have a permanent home to live in. • Not having a permanent home can lead to stressors that caused participants to leave the intervention program early. Oftentimes people in these programs face great stressors and face various challenges. • Many may live with family and move frequently. • Frequently moving caused many participants not to have adequate transportation to the health center where their case manager was located.

25. THANK YOU Dr. Cynthia Barnes-Boyd Ms. Washington LaReina C. Anthony SROP Staff Fellow SROP Scholars