A community-academic partnership Promoting healthy lifestyles for chronic disease prevention among Hispanic farmworking families along the US-Mexico border: A community-academic partnership Rachana Sikka, MA, MPH1, Emma Torres, MSW2, Ana Martinez, MSW3, Fannie Fonseca-Becker, Dr.PH, MPH3 Methods: Reporting Data Population Description Project Background Examples of data to report as outcomes: Changes  in knowledge and self-efficacy regarding physical activity and nutrition behaviors Changes in the behaviors themselves (e.g. levels of physical activity, eating recommended levels of fruits and vegetables, cooking with healthy oils)   Hispanic farmworkers have limited English language skills, low incomes, low educational attainment and little or no access to health services. Diabetes prevalence among Hispanics living near the U.S./Mexican border is more than twice the prevalence among non-Hispanic whites living in the same area (Teufel et al., 2005). Along the U.S.-Mexico border, overweight and obesity have reached epidemic proportions. Campesinos Sin Fronteras’ (CSF) is a nonprofit, grassroots organization in Somerton, AZ. CSF’s Familias Sanas Farmworker Family Prevention Initiative seeks to prevent cardiovascular disease, diabetes, and childhood obesity in Hispanic farmworking families along the US-Mexico border in Yuma County, Arizona. With funding support from the Johns Hopkins Community Healthcare Program (J&JCHP), CSF and the Johns Hopkins Bloomberg School of Public Health (JHBSPH) formed a community-academic partnership to evaluate the Familias Sanas Project. Process Outcomes Table 1: Sociodemographic characteristics of Somerton, AZ compared to Yuma County, Arizona and the United States One year after forming the partnership: 103 women participated in walking sessions or educational sessions. 37 children participated in educational sessions. 418 farmworkers receiving chronic disease prevention information in the workplace. 644 farmworker families received glucose and blood pressure health screenings at health fairs. Methods: Training and Activities Indicator United States* N=301,621,157 Arizona* n=61,666,318 Yuma County* n=187,555 Somerton/ S. Yuma County** n=8,180 Hispanic or Latino (of any race)% 14.8 29.2 55.9 95.2 Education Level (% age 25+) ≥High school graduate ≥ Bachelor’s degree 84.1 27.0 83.8 25.5 72.7 11.1 38.3 3.8 Living below poverty line (%) 13.3 14.2 18.5 26.6 Using a hands-on, participatory approach, grantee staff members actively contribute to improving the organization’s in-house capacity for monitoring and evaluation. The goal is to increase CSF’s long-term sustainability. Academic members make three site visits to the community organization over a two year period to provide training in monitoring and evaluation. Translating Knowledge into Practice JOHNS HOPKINS BLOOMBERG SCHOOL of PUBLIC HEALTH Conceptual Framework for Program Monitoring & Evaluation Background Variables Mediating Variables OUTCOMES Socio-demographic Age Sex Race/Ethnicity Marital Status Education Zip code Other individual Access to Transportation Psychosocial - Self-efficacy: Performing physical activity Preparing healthy foods Exposure to Program Intervention Healthy lifestyle sessions for women and children Behavior Level of physical activity Cooking with healthy oils Eating recommended levels of fruits and vegetables Eating 3 regular meals a day Fonseca- Becker, 2003 Insurance Status Knowledge: Biological measures Healthy nutrition Risk factors for chronic disease Recommended physical activity levels Partnership allowed student collaborator from JHBSPH to turn academic training into new knowledge and capacity within the Familias Sanas project. Partnership focuses on capacity-building, unlike consulting partnerships which provides a service for an organization. *U.S. Census, 2006 **U.S. Census, 2000 Cardiovascular disease, diabetes and obesity . Cardiovascular disease in the number one killer of Hispanics of Mexican origin. Sustainability Partnership will result in useful data that CSF will use for program improvement and future fundraising efforts. Table 2: Adult and child diabetes and obesity in Yuma County compared to Arizona and the United States Diabetes Obesity Adult Child Yuma County (n=187,555) >18 yrs: 7.2% (2005 data) N/A 24.2% (2001-2006 data) Arizona (n=61,666,318) 6.9% 25.4% (2007 data) 12% United States (N=301,621,157) >20 yrs: 10.7% <20 yrs: 0.2% 32.9% (2003-2004 data) 15.5% (2005-2006 data) For each task, academic collaborators from JHBSPH provide information and technical support, but rely on CSF partners to complete evaluation tasks. Specific activities include: Designing a conceptual framework of program activities and intended outcomes (see above) Revising survey instruments (pre and post tests for health education classes) Building a data management system using EpiInfo software for data collection and analysis. Sources: Centers for Disease Control and Prevention: National Diabetes Surveillance System; Centers for Disease Control and Prevention: National diabetes fact sheet: general information and national estimates on diabetes in the United States, 2007; 2003-2006 National Health and Nutrition Examination Survey; Bureau of Public Health Statistics, Health Status and Vital Statistics Section, 2007; Centers for Disease Control and Prevention: Behavioral Risk Factor Surveillance System Survey Data.2008; Ogden CL, et al. Obesity among adults in the United States – no change since 2003—2004. NCHS data brief no 1. Hyattsville, MD: National Center for Health Statistics, 2007; 2005 Behavioral Risk Factor Surveillance System and Youth Risk Behavior Surveillance System; Ogden CL, et al. High Body Mass Index for Age Among US Children and Adolescents, 2003—2006. JAMA. 2008;299(20):2401—2405. Dia Del Campesino (Day of the Farmworker) Health Fair, December 6, 2008 from 4am-12pm in San Luis, AZ 1 Department of Health, Behavior and Society, Johns Hopkins University School of Public Health, 624 N. Broadway Street, Baltimore, MD 21205, 612-701-7972, rsikka@jhsph.edu 2 Executive Director, Campesinos Sin Fronteras, Somerton, AZ. 3 Associate Director, Campesinos Sin Fronteras, Somerton, AZ. 4Director, J&J Community HealthCare Scholars Program, Johns Hopkins University Bloomberg School of Public Health