Reducing Metabolic Syndrome Risks for the Hispanic Worker: A Culturally Sensitive Approach Steven Marks, DNP, RN, APN, COHN-S, FAAOHN
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
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
Metabolic Syndrome Insulin Resistance Dyslipidemia Hypertension Obesity
Population at Risk Hispanic men - According to the American Heart Association (2015) 60 50 40 % of Population 30 20 10 2013 2015 0 CV Disease Stroke Prediabetes
Challenges with Target Population Wage Language Female dominant household Transportation Varying cultural backgrounds
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
Literature Review Latinos en Control study Disease management Interactive cooking sessions Health literacy and education Decreased barriers to care Improved outcomes
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)
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
Program Focus Whole grains Grilled foods Lean/inexpensive proteins Minimize processed foods Portion control Spice, not salt
Metabolic Syndrome Steven Marks, APN-C 1
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
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
Post Intervention Repeat Vital signs and measurements BP, Weight, BMI, Abdominal circumference Lab work Lipid panel, FBS, HgBA1C LDBQ
Data Comparison Mean Total LDBQ Score 30 LDBQ Score 25 20 15 10 5 0 Pre Post Intervention Group 19.8 24.2 Non-intervention Group 23.3 21.7 Mean total LDBQ score. This chart compares the mean total scores of both the intervention and nonintervention groups.
Data Comparison Pre and Post Intervention Body Measurements and Blood Pressure Group Measurement Pre M Post M % Change Intervention Weight 192.25 190.08-1.13 Abd Circ 41.50 40.46-2.50 BMI 31.17 30.82-1.11 Systolic BP 114.77 113.85-0.80 Diastolic BP 75.85 76.00 0.20 LDBQ Score 19.77 24.23 22.57 Non Intervention Weight 232.53 231.47-0.46 Abd Circ 46.17 45.33-1.81 BMI 36.37 36.20-0.46 Systolic BP 114.00 101.33-11.11 Diastolic BP 64.67 66.00 2.06 LDBQ Score 23.33 21.67-7.14
Data Comparison Pre and Post Intervention Laboratory Values Group Measurement Pre M Post M % Change Intervention FBS 102.67 96.83-5.68 HGB A1C 5.91 5.87-0.71 Cholesterol 184.33 183.33-0.54 LDL 114.25 111.36-2.53 Triglyceride 127.08 170.67 34.30 HDL 44.67 40.58-9.14 Non Intervention FBS 107.00 94.33-11.84 HGB A1C 6.27 6.13-2.13 Cholesterol 176.00 171.67-2.46 LDL 102.00 111.33 9.15 Triglyceride 161.67 112.67-30.31 HDL 41.67 38.00-8.80
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
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
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Questions? Steven Marks, DNP, RN, APN, COHN-S, FAAOHN Email: smarks@vikingyachts.com