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COLLABORATIVE US-MEXICO BORDER DIABETES PREVENTION PROJECT

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COLLABORATIVE US-MEXICO BORDER DIABETES PREVENTION PROJECT

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    1. COLLABORATIVE US-MEXICO BORDER DIABETES PREVENTION PROJECT Presenters: Gloria Beckles Rodolfo Valdez

    3. Border Population I About 70% Hispanic High annual growth rates (3.1% for Mexico and 2.4% for U.S) The rates suggest that the US/MX border population will double in about 25 years.

    4. Border Population II High poverty levels on both sides of the border A large portion of the Hispanic population is uninsured or underinsured Several US border communities are designated “Medically Underserved Areas”

    5. Diabetes Mortality Rates for Selected US-Mexico Border Communities, 1995-1997

    6. Diabetes Mortality Rates/100,000 in Selected US-Mexico Border Counties and Municipalities, 1992-1994 / 1995-1997

    7. Description This is a five-year US-Mexico collaborative project to determine the prevalence of diabetes along the US-Mexico border and to develop binational diabetes prevention and control programs specific to the needs of the border population

    8. Partners Pan American Health Organization US-Mexico Border Health Association Centers for Disease Control and Prevention Secretaría de Salud de México State Health Authorities and Diabetes Control Programs of: Arizona Baja California California Chihuahua New Mexico Coahuila Texas Nuevo León Sonora Tamaulipas Paso del Norte Health Foundation El Paso Diabetes Association Border Health Foundation California Endowment / Project Concern International

    11. Funding CDC awarded PAHO $824,000 for project activities Paso del Norte Health Foundation has assigned more than $400,000 for the prevalence study in its area of influence (Texas). Texas Department of Health contributed $60,000. New Mexico Department of Health contributed $80,000 to fund the position of US Coordinator. California Endowment awarded the Border Health Initiative of Project Concern International $272,000 to fund project activities in California

    12. Management PAHO coordinates activities supported by: Executive Committee Scientific Committee Workgroups Intervention Advisory Committee Workgroups CDC and SSM advisors

    13. Rationale Diabetes is common among people of Mexican ancestry. The prevalence of diabetes along the US/MX border is unknown. Health Departments in the US border states are concerned that the information from the statewide BRFSS may not be applicable to the border population.

    14. Purpose The purpose of the project is two-fold: Assess the burden of diabetes and related factors in the border population. Provide information for diabetes program development and implementation.

    15. Objectives Phase I Prevalence of diabetes Prevalence of lifestyle factors Access to/Quality of health care Data analysis Literature review of community interventions Phase II Intervention

    16. Sample I Persons aged 18 years or older Counties contiguous with US/MX border Residents of census tracts in counties with cities of 50,000 people or more Residents of census tracts in municipalities with 2,500 people or more

    17. Sample II: US Strata Arizona California-San Diego County California-Imperial County New Mexico Texas-El Paso County Texas-Other counties Within each stratum two ethnic groups (Hispanic, Non-Hispanic) will be selected

    18. Sample III: Mexico Strata Baja California Sonora Chihuahua Coahuila Nuevo León Tamaulipas

    19. Sample size: US

    20. Sample size: Mexico / Total

    21. Data Collection Questionnaire (Demographics, behavioral risk factors, access to health care, quality of care) Venipuncture (FPG, HbA1c) BP measurement (SBP, DBP, HBP) Anthropometry (Ht, Wt, WC)

    22. Prevalence estimates Diabetes prevalence estimates for US-México Border region US Border population Hispanic Non-Hispanic México Border population Border population of each state

    23. Current Status I Household questionnaires and operation manuals have been developed in English and Spanish A field test has been completed in El Paso and Ciudad Juárez area A binational sample design has been developed Communities to be surveyed have been selected Communication plan is being developed

    24. Current Status II IRB approvals have been obtained from the US and Mexico OMB approval has been obtained (US) Laboratories for blood analyses have been identified Inventory of interventions has been created The survey is about to start in the Texas-New Mexico-Chihuahua and California-Baja California regions

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