Harlem Healthy Heart: A Community Outreach Initiative With Favorable Impact on Diabetes Mellitus and Cardiometabolic Risks

Sunday, 22 July 2018

Renee Murray-Bachmann, EdD, CDN, RN, CDE, CPT
NEPD, Northwell Health System- Lenox Hill Hospital, New York, NY, USA
Icilma Fergus, MD
Cardiology/Icahn School of Medicine, Mount Sinai Medical Center, New York, NY, USA

Purpose: African/Caribbean Americans are more likely to be diabetic, physically inactive, overweight and less likely to have controlled blood pressure as compared to Whites(Clark et al, 2013;Puckerin & Howard, 2015). Excess body weight, even modestly, and physical inactivity not only increase the risk for cardiovascular disease but are associated with a 3- fold increase in the risk for diabetes mellitus development. Blacks participate in risk reduction behaviors, such as diet control, exercise and medication adherence at lower rates than other racial groups (Puckerin & Howard, 2015). As such disparities continue to exist, the prevalence, morbidity and mortality related to the above noted conditions in this population will be significant. Urban communities are more likely to be impacted by outreach efforts such as health fairs - though this intervention is not efficacious long term(Aycock, Kirkendoll & Gordon, 2013; Hu et al, 2014;Clark et al., 2013). Methods: Towards continued community impact, a culturally sensitive series concept was interprofessionally developed and implemented to impact the entire family. It involves an ongoing series of 12 monthly workshops focusing on education, screening, diet, exercise and referral with an aim to controlling cardiometabolic risk. Since stress, anxiety and depression have been shown to be important risk factors for cardiovascular health issues, and quite prevalent in urban population beginning with the youth (Slopen et al., 2013), participants are taught to recognize and handle inner stress. Central Harlem was chosen because of the large population of ethnic minorities. In Central Harlem, where the series is held, it has been noted that 12% of adults have diabetes as opposed to 7% in the Borough of Manhattan ( where Central Harlem is located) and 9% in New York City overall. Therefore, it was requested by the community stakeholders that a diabetes education component be included in the series of monthly workshops. Results: A survey of the 97 regular participants (86% female and 92% African or Caribbean American) resulted in 20% responding that they were previously diagnosed with diabetes mellitus. As a response, a diabetes screening (leading to diagnostic testing) was offered and an additional 9% of the participants were diagnosed. Conclusion: This series includes input and buy-in from stakeholders (e.g. Community residents, institutions of higher learning, faith based organizations and community medical providers) and indicators such as weight loss, blood glucose and blood pressure control (amongst the participants) have been noted. Qualitative data themes, including enhanced quality of life, have been acquired during participant feedback. This type of grassroots approach will undoubtedly result in a reduction in premature morbidity and mortality within this population.