More than 200 North Carolinians gathered at Halifax Community College on a Saturday in March with one goal in mind: improving their health.
They underwent the usual blood pressure tests, cholesterol checks, dental screenings and breast exams. But many also took the opportunity to join an innovative new program that could potentially save their lives and improve the health of future generations.
Barbara Ramsay was among those who signed up for the Diabetes Family Project, a community-based intervention and research project spearheaded by Dr. Natasha Greene Leathers, Ph.D., an assistant professor of nursing at NCCU School of Nursing and a practicing family nurse practitioner. The goal is to learn effective ways of helping African-Americans manage and prevent Type 2 diabetes.
“I hope it can help me limit my diet and eat healthier foods. I’m ready to get into it; I want to learn,” said Ramsey, who was diagnosed with Type 2 diabetes 15 years ago.
The project is funded with a portion of a $5.7 million grant from the National Institutes of Health awarded to the Julius L. Chambers Biomedical/Biotechnology Research Institute at NCCU to focus on cardio-metabolic diseases that disproportionately affect African-Americans and individuals who have limited access to health care.
According to the American Diabetes Association, more than 26 million people in the U.S. have diabetes, and nine out of 10 of those have Type 2 diabetes.
Unlike those with Type 1, whose bodies can’t make insulin, people with Type 2 diabetes make insulin, but it is not efficiently used by their bodies to break down blood sugar. This can potentially cause a host of problems, including damage to nerves and small blood vessels in the eyes, kidneys and heart.
Why diabetes develops in some people and not others isn’t completely known. But risk factors include age – individuals 45 and older are at greatest risk – being overweight, having family members with diabetes, leading a sedentary lifestyle and having high blood pressure, as well as being members of certain minority groups, including African-Americans.
Diabetes occurs in about 12 percent of the African-American population, compared to 8 percent for the nation as a whole. In Eastern North Carolina, the rate of diabetes is even higher for African-Americans, with some estimates of more than 15 percent.
Greene Leathers points to a number of things that may contribute to African-Americans’ higher incidence of diabetes, including a shortage of health professionals to provide preventative health care and the economic conditions of rural North Carolina communities.
A North Carolina Justice Center report shows that while employment rose between 2009 and 2013 by 5.6 percent in metropolitan areas and 4.9 percent in small cities across the state, rural areas suffered job losses of 13.5 percent. Such economic conditions have an impact on food choices, as well as the ability to go in for regular checkups or to buy needed medications.
“When we started the project, we tried to think about all the things people need in order to have access to health care,” Greene Leathers said.
That’s when she and study coordinator, social clinical research assistant Pamela Douglas, got creative. They and a team from the NCCU Department of Psychology, led by Dr. Sherry Eaton, organized focus groups of residents in the target area of Halifax County and invited them to talk about their wants, needs and preferences in regard to health education and other services. Information gleaned from the meetings gave organizers a better idea of how to set up the program so that it would have the highest chance of success.
Among the suggestions they received was for classes to address certain topics that health-conscious individuals often wrestle with, such as ways to make healthful meals that taste good, how to exercise without access to a gym, and how to get their families on board with their plans to eat better and stay active.
They also remarked that it was going to be tough to commit to a schedule that offered services only during the hours of 9 to 5.
“Some people with jobs aren’t free during the day, so we decided to offer services in the evenings to accommodate people who work,” Greene Leathers said.
And because most people “don’t live in isolation,” the Diabetes Family Project requires each of the individuals enrolled to recruit a family member to participate with them, she added.
“We felt that opening the program up to their loved ones would provide the support that would help maintain healthier behavior,” Greene Leathers said.
Mironica Ramsay is participating along with her mother, Barbara.
“I believe this will help me learn about the disease and how to avoid it, as well as help Mama control it,” Mironica Ramsay said. “If I learn how you get it, maybe I won’t get it.”
To get the word out to citizens, Greene Leathers and Douglas connected with a variety of established groups and agencies in the Halifax County area. They networked with churches, health care providers, community centers, schools and just about anywhere the people they hoped to reach were likely to gather.
“I first heard about it from the health fair at St. Paul’s Baptist Church,” said Laura Daniels, who signed up to participate along with her mom, Laura Bunn, who is considered pre-diabetic because of high sugar levels in her blood.
“My grandmother and her older sister had it,” Laura Daniels said. “My baby brother who is 50, he’s had it. I say the more you know, the better you can treat what you have.”
In order to further bring the message home, the Diabetes Family Project hired and trained a group of local residents to lead the educational sessions that will be ongoing throughout the project. The local residents know how to “speak the language” of their neighbors and are more naturally sensitive to their wants and needs, Greene Leathers said. Robin Barnes of Scotland Neck is among those who signed up to do the training.
“Diabetes is in my family too, so I’m having the opportunity to learn as much as possible and share that information with others in my community – my family and my friends,” Barnes said. “Maybe we can help the younger generation, because they will learn things we might not have known growing up.”
Participants in the yearlong program attend health education classes once a week for eight weeks, on Tuesday or Thursday evenings, at a location within a dozen or so miles of their homes. They are offered incentives like pedometers, exercise equipment and cookbooks. And healthy food samples are available for tasting.
Throughout the study period, participants are given blood tests every three months to see whether their blood sugar levels, cholesterol and other factors are improving.
Renee Blazek was one of about 20 nursing students from NCCU who were on hand to assist at the kick-off health fair at Halifax Community College in March.
“It’s hard but worth it,” she said, after spending many hours in Weldon setting up and administering the blood tests and other elements of the health fair.
That sentiment was seconded by Araba Awotwi, who graduated from NCCU in May and will begin working toward her doctoral degree in nursing at the University of North Carolina-Chapel Hill in fall 2014.
“As a nursing student I learned a lot about drawing blood and working with people in varying stages of health,” Awotwi said.
“And the community was so excited that we were there for them. It was encouraging to see patients begin to understand that, while their condition is serious, education can help them have a better quality of life and a longer life span. They feel empowered. That’s what happens when you give people information.”
Article as seen in the spring 2014 issue of NCCU Now, a magazine for the faculty, staff, alumni and friends of North Carolina Central University. See our archives of past issues at http://issuu.com/nccentraluniv .
Photos by Ivan Watkins Photography
Homepage image caption: Student Stanley Nwabinwe takes blood from participants, whose progress toward health is being monitored.