Type-2 Diabetes in Belize: A Cross-Sectional Study and Holistic Approach to Increasing Health Education

By Brown, Shelley M.; Monahan, Anna et al. | International Public Health Journal, July 1, 2013 | Go to article overview

Type-2 Diabetes in Belize: A Cross-Sectional Study and Holistic Approach to Increasing Health Education


Brown, Shelley M., Monahan, Anna, Daniels, Jena E., Burton, Tracy R., International Public Health Journal


Introduction

Type 2 diabetes is a metabolic disorder that is characterized by insulin resistance. Cells fail to use insulin properly, while in some cases, there is complete insulin deficiency. The defective insulin action, insulin secretion, or both, cause the presence of hyperglycemia. Hyperglycemia can lead to significant mortality, morbidity, and significant costs of rehabilitation and tertiary care (1,2). In recent years, type 2 diabetes has become the leading cause of deaths Belizeans, as of 2005 (2). This trend is evidenced by the quality of care that patients receive who are experiencing the disorder, suffer from one or more other chronic conditions, or both.

The prevalence of Type 2 diabetes is rising in Belize due to an increase in obesity and physical inactivity, aging, population growth, and urbanization (3). The modifiable risk factors that are independent of each other are low physical activity and obesity (4). In a holistic approach to combat these two aspects, the present cross-sectional study took part in increasing the general public's knowledge regarding overall health by hosting health care clinics and educational booths, distributing culturally appropriate handouts to targeted communities, implementing educational programs in the school systems included in the study, and testing willing participants for Type 2 diabetes.

Boston University undergraduate students, in collaboration with faculty and a registered nurse from Winchester Hospital, hosted healthcare clinics that were both mobile and stationary. With the traveling clinics, the sample size became more diverse and education expanded beyond the school systems. The stationary clinics were organized in the center of the town of Punta Gorda where the majority of individuals participated in the study. Other sites included school classrooms, health clinics, and other health care facilities. Supplementing the testing at clinics, an education booth, staffed by Boston University students and faculty, was available. Culturally specific and appropriate information was distributed regarding type 2 diabetes care and prevention, culturally relevant diet-based prevention, and educational materials on other public health issues common to the region. Contact information for the local primary care physicians was also made available.

Concluding each testing session at the clinics, participants were handed an index card containing all of the data recorded for the study with a recommendation section. In correspondence with the trauma nurse that travelled with the students to each clinic, the recommendation section of the card clearly stated if there was a significant need to visit a local doctor, diet and exercise alterations, as well as indications for high or low blood pressure and/or blood glucose levels.

The other major component to increase the public's awareness of type 2 diabetes and its precursors was focused on the school system, where the undergraduate students taught in elementary-aged classrooms about health, nutrition, exercise, stress and hygiene. Depending on the age level and working knowledge of various topics, each lesson plan was tailored according to NEEMA principles from the Journal of National Medical Association (10). The outline of the Belizean study stems from the core of NEEMA. In addition, the school systems were targeted for their lack of available healthy food choices and specific educational programs. The intention of the implementation of educational programs, where previously they were lacking, is to target the modifiable risk factors for type 2 diabetes and positively influence the students to make healthier lifestyle choices. The principals and classroom teachers also participated with the children in the various health-related activities and lesson plans. Participation by the administration demonstrates the commitment of the local community to support healthier choices for students and their families.

With the ability to personalize and tailor the lesson plans in the classrooms and focus the health care clinics on specific common health disparities in Belize, transformation to a unique community- focused program occurred. …

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