Transcript Update on ATS Education Committee

Presenter Disclosures
Elizabeth Bertera PhD
Silvia Martinez, EdD
(1)
The following personal financial relationships with
commercial interests relevant to this presentation
existed during the past 12 months:
“No
relationships to disclose”
Presenter Disclosures
Elizabeth M. Bertera, PhD
Silvia Martinez, EdD
Talking Fotonovelas to Educate
Older African Americans about
Diabetes and High Blood Pressure
Elizabeth M Bertera, PhD
Associate Professor, School of Social Work, Howard University, Washington DC
[email protected]
Silvia Martinez, EdD
Assistant Professor, Dept of Communication Sciences and Disorders, Howard
University, Washington DC
[email protected]
Presented at the Annual Meeting of the American Public Health Association,
Philadelphia, PA, November 8, 2009
The project was supported with funding from the Centers for Medicare & Medicaid
Study Purpose
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The purpose of this study is to evaluate an
educational intervention, Talking
Fotonovelas.
Skill building activities are integrated into
the session and tailored to age, culture,
and lower literacy.
The Talking Fotonovelas, produced with
standard application software, contain
photographs and dialogue bubbles, similar
to comic books, that include images and
voice-over using participants from the
community.
Outcome Variables
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Increased Self-efficacy Related to
Nutrition and Physical Activity.
Improved health knowledge,
attitudes and practices about
nutrition and physical activity.
Separate scales measure outcomes
for diabetes and hypertension.
Study Hypotheses
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H1 Older African Americans will improve their
knowledge, attitudes and practices (KAP)
related to diabetes and high blood pressure.
H2 Improvement in diabetes and high blood
pressure KAP will be positively associated
with increases in self-efficacy after exposure
to the Fotonovelas.
H3 Improvement in diabetes and high blood
pressure KAP will be positively associated
with increases in self-efficacy after exposure
to the Fotonovelas , even after controlling for
moderator variable effects (higher health
literacy, higher educational attainment,
higher exposure to FT and younger age).
Design for Talking Fotonovelas (TF)
Study:
200 intervention and
200 comparison group participants
Study
Group
Intervention
Groups
Year 1
Focus Groups
Pre1, TF#1 (N=50) Post1
Year 2
Pre2, TF#2 (N=50) Post2
Pre3, TF#3 (N=50) Post3
Pre4, TF#4 (N=50) Post4
Comparison
Surveys
Baseline (N = 100)
Post Survey (N = 100)
What are you putting on the chicken?
I use onion powder.
We put our forks down
between bites.
It help us to chew well and
enjoy our food.
KAP & Self-Efficacy Gaps Identified by
Focus Group Results (based on NDEP Guidelines)
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Know when and how to test your blood
glucose
Eat regular meals that contain a variety of
healthy, low-fat, high-fiber foods, including
fruits and vegetables each day; eat smaller
portions of meat, fish and poultry
Get physical activity each day:30-60 min on
most days
Follow your foot care plan: check feet every
day
Keep all appointments and have feet, eyes,
and kidneys checked at least once a year
Visit your Dentist twice a year; brush & floss
daily
Seek help if you feel down
Baseline Survey Demographics
Sample
Characteristic
Percent
(N=58)
Female
81
African American
95
High School
Education or more
70
Annual Income <
96
Diabetes Treatment Status
Sample Characteristic
Percent
(N=58)
Dx of Diabetes by an MD
59
Takes Diabetes Medication
40.4
Takes Insulin
3.5
Hypertension Treatment Status
Sample Characteristic
Percent
(N=58)
Dx of Hypertension by an MD
87.9
Takes High BP Medication
89.7
Check Blood Pressure
Regularly
44.8
Diabetes Related Goals – Next 12
Months (% Strongly Agree)
Feel Better
Be More Physically Active
Prevent/Delay Complications
Learn to Control Diabetes
Learn to Eat
Lose Weight
0
20
40
60
80
100
Current Behavior and Behavioral
Intention: Nutrition & Physical
Activity (% Strongly Agree)
Eat Healthily Now
Want to Eat More Healthily
Enough Physical Activity Now
Want to be More Physically Active
0
10
20
30
40
50
60
70
80
90
100
Diabetes Self Efficacy Scores
(1=Not at all Confident, 10=Totally Confident)
Get Regulat Exams
Properly Fitted Shoes
Take Meds on Time
Know When to Visit MD
Choose Healthy Foods When Hungry
Control Diabetes
Eat Healthily When With Non-Diabetics
Get Physical Activity More Often
Handle Stress
Increase Duration of Physical Activity
Prevent Diabetes
Manage When BG increases
0
2
4
6
8
10
Pre and Post Assessments
Skill Building to Improve
Portion Control
Summary
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Knowledge and self-efficacy gaps
identified by focus groups and
baseline survey
Participants show strong interest in
learning how to manage diabetes
and hypertension through healthier
eating and increased physical
activity.
Initial recruitment of African
American older adults through Senior
Housing and Senior Center partners
has been successful.
Implications
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There is an unmet need for diabetes
and hypertension education in the
African American older adult
community.
Nutrition and physical activity topics
are the areas of greatest interest and
need.
Acknowledgement
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Agnelli Sybel, MPH, MPA, Research
Program Project Specialist
Gregory Bacourt, Research Assistant and
PhD student, School of Social Work
Olivia Drake, MFA, Research Assistant and
PhD student, School of Communications
Claudia Thorne, MSW, LISW, Research
Assistant and PhD student, School of
Social Work