title: Healthy eating and exercising to reduce diabetes: exploring the potential of social determinants of health frameworks within the context of community-based participatory diabetes prevention.
abstract: OBJECTIVE
  We examined a community-based participatory diabetes intervention to identify facilitators of and barriers to sustained community efforts to address social factors that contribute to health.
  
  
  METHODS
  We conducted a case study description and analysis of the Healthy Eating and Exercising to Reduce Diabetes project in the theoretical context of a conceptual model of social determinants of health.
  
  
  RESULTS
  We identified several barriers to and facilitators of analysis of social determinants of a community-identified disease priority (in this case, diabetes). Barriers included prevailing conceptual models, which emphasize health behavioral and biomedical paradigms that exclude social determinants of health. Facilitating factors included (1) opportunities to link individual health concerns to social contexts and (2) availability of support from diverse partners with a range of complementary resources.
  
  
  CONCLUSIONS
  Partnerships that offer community members tangible resources with which to manage existing health concerns and that integrate an analysis of social determinants of health can facilitate sustained engagement of community members and health professionals in multilevel efforts to address health disparities.
authors.affiliation: Health Behavior and Health Education, University of Michigan School of Public Health, 1420 Washington Heights, Ann Arbor, MI 48109, USA. ajschulz@umich.edu
authors.forename: Amy J
authors.initials: AJ
authors.lastname: Schulz
authors.forename: Shannon
authors.initials: S
authors.lastname: Zenk
authors.forename: Angela
authors.initials: A
authors.lastname: Odoms-Young
authors.forename: Teretha
authors.initials: T
authors.lastname: Hollis-Neely
authors.forename: Robin
authors.initials: R
authors.lastname: Nwankwo
authors.forename: Murlisa
authors.initials: M
authors.lastname: Lockett
authors.forename: William
authors.initials: W
authors.lastname: Ridella
authors.forename: Srimathi
authors.initials: S
authors.lastname: Kannan
mesh_terms: D000328:Adult; D001741:Black or African American; D003153:Community Health Services / Q000458:organization & administration*; D003920:Diabetes Mellitus / Q000178:diet therapy / Q000453:epidemiology / Q000208:ethnology* / Q000517:prevention & control*; D005081:Exercise Therapy; D005260:Female; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D008824:Michigan / Q000453:epidemiology; D012959:Socioeconomic Factors; D014505:Urban Population; D016387:Women's Health