A model for using community-based participatory research to address the diabetes epidemic in East Harlem.
OBJECTIVE
Diabetes prevalence and mortality are increasing, with minority populations disproportionately affected. Despite evidence that weight loss due to improved nutrition and increased physical activity can prevent or control diabetes, there is often a disconnect between this evidence and individuals' lifestyles.


METHODS
East Harlem is a predominantly African-American and Latino neighborhood that has the highest rates of diabetes prevalence and mortality in New York City. The East Harlem Diabetes Center of Excellence is a community-centered coalition. To help direct their work, the coalition used their experiences, research, outreach, and literature review to build a conceptual model describing how local factors affect health behaviors and health outcomes such as obesity and diabetes.


RESULTS
This model describes the relationship between the physical environment, the social/medical environment and individual factors including demographic data, food and exercise beliefs and behaviors, and health outcomes. The coalition inserted local data from surveys and focus groups into the model to identify targets for future interventions, research, and activism.


CONCLUSIONS
This type of collaboration and the model may be useful tools to help communities identify and address the deficits that prevent their residents from enjoying the health benefits of improved nutrition and increased physical activity, and that also lead to racial and ethnic disparities in health.
Horowitz
Carol R
CR
Department of Health Policy and Medicine, Mount Sinai School of Medicine, New York, NY 10029, USA. carol.horowitz@msnyuhealth.org
Goldfinger
Judith Z
JZ
Muller
Sara E
SE
Pulichino
Romina S
RS
Vance
Thomas L
TL
Arniella
Guedy
G
Lancaster
Kristie J
KJ
D000328:Adult; D001741:Black or African American; D018672:Community Health Planning; D003299:Cooperative Behavior; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000401:mortality; D004196:Disease Outbreaks; D016021:Epidemiologic Studies; D005260:Female; D017144:Focus Groups; D006306:Health Surveys; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D009043:Motor Activity; D009519:New York City / Q000453:epidemiology; D009752:Nutritional Status; D010358:Patient Participation; D015995:Prevalence; D012111:Residence Characteristics; D012931:Social Environment