Reducing Metabolic Syndrome Risks for the Hispanic Worker: A Culturally Sensitive Approach. Steven Marks, DNP, RN, APN, COHN-S, FAAOHN

Transcription

1 Reducing Metabolic Syndrome Risks for the Hispanic Worker: A Culturally Sensitive Approach Steven Marks, DNP, RN, APN, COHN-S, FAAOHN

2 Who, What, When, Where, How but most importantly WHY? Who - Hispanic workers at Viking Yachts What Metabolic syndrome When 2015 Where Rural South Jersey How Full management support

3 WHY? Speak in a language they understand Not just Spanish A life language Acknowledge their culture Hispanic is not necessarily Mexican Favorite foods Cooking methods Who cooks and shops Ideas about body shape and disease Income

4 Metabolic Syndrome Insulin Resistance Dyslipidemia Hypertension Obesity

5 Population at Risk Hispanic men - According to the American Heart Association (2015) % of Population CV Disease Stroke Prediabetes

6 Challenges with Target Population Wage Language Female dominant household Transportation Varying cultural backgrounds

7 Literature Review 53 million Hispanic/Latino in US in 2011 Hispanic population at increased risk due to: Barriers to healthcare Transportation Availability of affordable healthy food choices Differing cultural norms Body image Health care beliefs

8 Literature Review Latinos en Control study Disease management Interactive cooking sessions Health literacy and education Decreased barriers to care Improved outcomes

9 Project Pre-Intervention Handouts and posters in work area Participant consent Baseline vitals and measurements BP, Height, Weight, Abdominal Circumference and BMI Baseline labs Fasting blood sugar, Lipid panel and Hgb A1C Latino Dietary Behavior Questionnaire (LDBQ)

10 Project Intervention Education session Spanish interpreter Metabolic Syndrome Nutrition Live cooking session Techniques and tips Family style meal Female household members invited Time for questions Healthy Hispanic recipes and food baskets

11 Program Focus Whole grains Grilled foods Lean/inexpensive proteins Minimize processed foods Portion control Spice, not salt

12 Metabolic Syndrome Steven Marks, APN-C 1

13 Menu Grilled pork on bamboo skewers Skewers soaked in agave to mimic sugar cane Fish stew Fish portions $1.00 each Marinated grilled chicken thighs $0.99/lb Demonstrated skin removal and boning to save money

14 Menu Green beans with bacon Frozen beans 4 slices of bacon cooked well and dried Crumbled to infuse flavor not fat to dish Coconut pudding Lower calorie and fat recipe Tres Leches cake Portion control with mini muffin tins

15 Post Intervention Repeat Vital signs and measurements BP, Weight, BMI, Abdominal circumference Lab work Lipid panel, FBS, HgBA1C LDBQ

16 Data Comparison Mean Total LDBQ Score 30 LDBQ Score Pre Post Intervention Group Non-intervention Group Mean total LDBQ score. This chart compares the mean total scores of both the intervention and nonintervention groups.

17 Data Comparison Pre and Post Intervention Body Measurements and Blood Pressure Group Measurement Pre M Post M % Change Intervention Weight Abd Circ BMI Systolic BP Diastolic BP LDBQ Score Non Intervention Weight Abd Circ BMI Systolic BP Diastolic BP LDBQ Score

18 Data Comparison Pre and Post Intervention Laboratory Values Group Measurement Pre M Post M % Change Intervention FBS HGB A1C Cholesterol LDL Triglyceride HDL Non Intervention FBS HGB A1C Cholesterol LDL Triglyceride HDL

19 Limitations Short time frame 6 weeks between pre and post intervention screening Location and transportation 3 participants got lost and did not attend live session Non-intervention group did get education materials

20 Clinical Implications Culturally sensitive education is effective Well received Many education projects can benefit from cultural awareness Ability to address the specific needs of the population Not cookie cutter education Decreased barriers to care Improved health outcomes and decreased cost of care

21 References American Diabetes Association. (2013). Economic costs of diabetes in the U.S. in Diabetes Care, American Heart Association. (2013). Statistical fact sheet : Retrieved from American Heart Association. (2015). Statistical fact sheet 2015 update: Hispanics/Latinos & Cardiovascular Diseases. Retrieved from Boudreau, D. M., Malone, D. C., Raebel, R. A., Fishman, P. A., Nichols, G. A., Feldstein, A. C.,... Okamoto, L. J. (2009). Health care utilization and costs by metabolic syndrome risk factors. Metabolic Syndrome and Related Disorders, 7(4), Abstract retrieved from PubMed. (Accession No. PMID: ) Fernandez, S., Olendzki, B., & Rosal, M. C. (2011, April). A dietary behaviors measure for use with low-income, Spanish-speaking Caribbean Latinos with type 2 diabetes: The Latino Dietary behaviors Questionnaire. Journal of the American Dietetic Association, 111, Ford, E. S. (2005, July). Risks for all cause mortality, cardiovascular disease, and diabetes associated with metabolic syndrome. Diabetes Care, 28, Grundy, S. M., Hansen, B., Smith, Jr, S. C., Cleeman, J. I., & Kahn, R. A. (2004). Clinical management of metabolic syndrome: Report of the American Heart Association/ National Heart, Lung and Blood Institute/ American Diabetes Association: Conference on scientific issues related to management. Arteriosclerosis, Thrombosis and Vascular Biology, 24, Haynes, D., Pruitt, R., Watt, P., Parker, V., & Price, K. M. (2010). Controlling metabolic syndrome in the Latino population: Support for the current guidelines. Hispanic Health Care International, 8, Huang, P. L. (2009, May-June). A comprehensive definition for metabolic syndrome. Disease Models & Mechanisms, 2, Lennie, T. A. (2006). The metabolic syndrome. Circulation, 114, e528-e Lindberg, N. M., Stevens, V. J., & Halperin, R. O. (2013, January 28). Weight-loss interventions for Hispanic populations: The role of culture. Journal of Obesity, 2013, Mishra, S., Xu, J., Agarwal, U., Gonzalez, J., Levin, S., & Barnard, N. (2013). A multicenter randomized controlled trial of a plant-based nutrition program to reduce body weight and cardiovascular risk in a corporate setting: The GEICO study. European Journal of Clinical Nutrition, 1-7. Rosal, M., Ockene, I. S., Restrepo, A., White, M. J., Borg, A., Olendzki, B.,... Reed, G. (2011, April). Randomized trial of a literacy-sensitive, culturally tailored diabetes selfmanagement intervention for low-income Latinos. Diabetes Care, 34,

22 Questions? Steven Marks, DNP, RN, APN, COHN-S, FAAOHN