Article

Obesity Prevention and Diabetes Screening at Local Health Departments

National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341-3727, USA.
American Journal of Public Health (Impact Factor: 4.55). 08/2010; 100(8):1434-41. DOI: 10.2105/AJPH.2009.168831
Source: PubMed

ABSTRACT

We assessed whether local health departments (LHDs) were conducting obesity prevention programs and diabetes screening programs, and we examined associations between LHD characteristics and whether they conducted these programs.
We used the 2005 National Profile of Local Health Departments to conduct a cross-sectional analysis of 2300 LHDs nationwide. We used multivariate logistic regressions to calculate odds ratios (ORs) and 95% confidence intervals (CIs).
Approximately 56% of LHDs had obesity prevention programs, 51% had diabetes screening programs, and 34% had both. After controlling for other factors, we found that employing health educators was significantly associated with LHDs conducting obesity prevention programs (OR = 2.08; 95% CI = 1.54, 2.81) and diabetes screening programs (OR = 1.63; 95% CI = 1.23, 2.17). We also found that conducting chronic disease surveillance was significantly associated with LHDs conducting obesity prevention programs (OR = 1.66; 95% CI = 1.26, 2.20) and diabetes screening programs (OR = 2.44; 95% CI = 1.90, 3.15). LHDs with a higher burden of diabetes prevalence were more likely to conduct diabetes screening programs (OR = 1.20; 95% CI = 1.11, 1.31) but not obesity prevention programs.
The presence of obesity prevention and diabetes screening programs was significantly associated with LHD structural capacity and general performance. However, the effectiveness and cost-effectiveness of both types of programs remain unknown.

Download full-text

Full-text

Available from: Huabin Luo, Sep 08, 2015
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Process evaluations are critical in determining whether outcome evaluations are warranted. This study assessed the extent to which a childhood obesity prevention initiative, NY Fit WIC, was adopted and implemented by the New York State Supplemental Nutrition Program for Women, Infants and Children (WIC). Process data came from qualitative telephone interviews of 101 WIC local agency directors, following NY Fit WIC trainings. Activities were summarized and cross-tabulated by target level (i.e. participant, staff, agency or community) and by theoretical construct (i.e. knowledge promotion, skill building, self-efficacy or role modeling). Approximately 528 activities were reported across all WIC agencies. When activities were grouped into similar categories, 123 unique activities were identified. Agencies were more likely to implement physical activity-related activities (67%) than nutrition-related activities (33%). The majority of activities targeted WIC participants (47%) and staff (22%) and focused on skill building/self-efficacy (67%) among participants and on role modeling (61%) among staff. The involvement of all agencies shows a high level of adoption of the initiative. The diverse number of activities suggests that WIC local agencies tailored implementation to match their resources and clients' needs as planned. These results suggest that an outcome evaluation is warranted to determine whether meaningful behavioral changes occurred among WIC participants and staff.
    Preview · Article · Nov 2011 · Health Education Research
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Local health departments (LHDs) vary in their capacity to perform public health services by the size of population they serve. Little is known about the extent of emerging primary prevention activities at small LHDs. The objectives of this study were to describe various diabetes-related patient care and primary prevention services offered by small LHDs (those serving a population of less than 150,000) and explore factors associated with the diversity of these services. During 2009 through 2010, we interviewed directors of a nationally representative sample of small LHDs by telephone to obtain information about staff structure, diabetes services, and partnerships. We obtained data for demographic characteristics and health status of the population from secondary sources. We analyzed the number of patient care services and primary prevention programs through multivariate regression analyses. Fifty-eight small LHDs completed the survey, a response rate of 81%. Most (n = 47) had at least 1 diabetes-related patient care service; referral to diabetes specialists was the most frequently identified service (n = 44). Nearly half of small LHDs also engaged in obesity prevention for adults (n = 26) or children (n = 26), but only 7 had a diabetes prevention program. Diversity of patient care services was positively associated with the proportion of the population that was rural, time commitment of a certified diabetes educator, and total staff size. Diversity of primary prevention programs was positively associated with intensity of collaboration with the state diabetes program and total staff size and inversely associated with the proportion of racial/ethnic minorities in the jurisdiction. Most small LHDs function as a link to local diabetes care services. Staff capacity, collaboration with the state health department, and local population factors appear to influence the diversity of diabetes-related services at small LHDs.
    Full-text · Article · Jan 2012 · Preventing chronic disease
  • [Show abstract] [Hide abstract]
    ABSTRACT: The rapidly increasing rate of non-insulin-dependent diabetes (NIDDM) among both market economy and developing countries is a worldwide health phenomenon. The number of diabetics worldwide has been projected to increase from 135 million in 1995 to 300 million in 2025. The purpose of this study was to examine the relative effectiveness of three different approaches to the implementation of the Diabetes Prevention Program, a standardized diabetes prevention curriculum, in various worksite organizations within a single community. The methods of implementation selected included an intensive one-on-one counseling approach, a support group meeting approach, and a passive transfer of information approach. The intervention was successful in creating significant mean improvements overall in the participants who completed the 26-week program as follows: (a) reduction in overall mean body weight and mean body mass index, (b) reduction in overall average mean arterial blood pressure, (c) reduction in overall mean diabetes risk score, and (d) increase in overall mean physical activity level. Although the largest proportion of these changes occurred in the one-on-one intervention group, significant changes in some factors were found in all groups. This illustrates the utility of an on-site and incentive-driven approach to diabetes risk factor modification in the workplace.
    No preview · Article · Jul 2012 · Health Promotion Practice
Show more