symptoms that when learning would help the target population to seek medical

attention. We would run this between January-June 2020.

o Objective # 3- Educate Hispanics about one of the causes of diabetes (overweight
and obesity) by performing measurements such as weight, BMI and fat percentage
and giving thoughtful feedback about the results. This would occur every other
Thursday during January-June 2020.
● Goal #5 - Provide visual information about diabetes in the form of pamphlets for
Hispanic residents to use as personal reference within the home.
○ Objective # 1 - Distribute at least 100 pamphlets in every church of El Paso,
Texas during January, February, and March of 2020
○ Objective # 2 - Distribute at least 100 pamphlets in the reception area of each
community clinic of El Paso, Texas, during January, February, and March of
2020.

Intervention Application

The Diabetes Prevention program's objective is to inform adult Hispanic in El Paso,

Texas and their relatives of the importance of modifying their eating habits, engaging in physical
activities, understanding the predisposition of diabetes, optimal blood sugar level and causes,
symptoms and complications of diabetes. We plan to accomplish it using health communication
strategies through dissemination of information like pamphlets and perform activities which
focus on the target population with the goal to modify their health behavior. Our intervention
will include several events where the target population with the help of health care professionals
engages in activities that may change their behavior. The description of these activities is
provided in will be the health modification strategy section. During the first month of our
intervention, we plan to use media communication to disseminate messages for Hispanics in El
Paso, Texas. We also plan to use the health education strategy which will accomplish the
function of teaching the target population the different types of diabetes, causes and what to do
in case of emergencies. The combination of these strategies will allow us to meet our objective.
The first phase of the program will be performed from January to June. Then we will evaluate
our intervention and make some adjustments if it is needed. A calendar with specific program
activities is included in this document.
The following persons will be running our programs
John Campbell – Program director: Initiate and set goals for the program according to the
program objectives. Oversees the other program’s managers and coordinator delegating
responsibilities and making necessary changes as needed.
Gerry Meissner – Program administrator: Under the supervision of the program director, the
program administrator coordinates the health care programs so it can run smoothly and at the
same time assigned other employees to work directly hand in hand with the target population.

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Stephanie Sorensen – Media administrators: Disseminate health education using different
means. is aware of the changes and needs of the target population and is up to date with
technology
Hilda Felix – Finance administrator: Maintain reports of financial records, and how they fund
can be distributed in the program.
Courtney Benegas - Health education specialist: Health educator teaches people about
behaviors that promote wellness. Will develop and implement strategies to improve the health of
individuals and communities. Will collect data and discuss health concerns with members of
specific populations or communities.
Letitia Castillo – group resource coordinator: Coordinates support classes and activities for
the target population and keep a detailed record of attendees and connect them with health care
facilities as needed.
Cinthia Morales - medical assistant: Performed necessary measurements like body weight,
BMI, fat percentage, blood sugar level.
Rhonda Quinton - dietitian specialist: Evaluates food intake journal and gives thoughtful
feedback to the participants about healthy and nutritious food.
Mariia – Volunteer: Serves as a resource person. Communicates with professionals that are
involved in the intervention. Manage the schedule of educational events like tests, presentations
and classes.
Veronica – Volunteer: Serve as a resource person Help with the dissemination of health care
information throughout the different locations where the target population meets. Connect the
target population with new classes and resource groups provided by the program.

Health Communication Strategies

Health communication strategies can be used as a supporting resource when promoting

health promotion. It can be used in intrapersonal and interpersonal level of influence. Our health
communication campaign is looking to inform Hispanic adults of El Paso and their relatives
about causes, symptoms and complications of diabetes, so they can change their eating habits to
prevent diabetes. By using this strategy, we provide our target population with resources that will
allow them to choose healthy and nutritious food and exercise activities to eliminate potential
causes of diabetes. In summary, we are looking for a change in the attitude of our target
population.
For the health communication strategy, we will use a combination of health behavior
model/theory by using the HBH model. This model states that a person's belief in a personal
threat of an illness or disease, together with a person's belief in the effectiveness of the
recommended health behavior or action, will predict the likelihood the person will adopt the
behavior. We plan to present the risk factors and causes of diabetes as a potential threat to health.
Hispanics are family center individuals. We will appeal to the love they have for their families

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and describe the influence of chronic disease like diabetes on members of family. We will
mention that their family members will feel sorrow for those who will develop diabetes.
By combining the previous model with the TTM, we want to create the desire to change
the behavior of target population. We understand the difficulty of this task, but we will use
reinforcement of the STC model which states that humans learn by observing and reflecting upon
the behaviors of role models. Reinforcement is necessary to see a result in our target population.
We plan to use pamphlets to introduce the information to our target population. These
pamphlets will contain detailed information about the causes, symptoms and consequences of
diabetes, particularly the risk of having high blood sugar level. We will introduce our target
population with medical tests that can help recognize causes of diabetes and introduce them to
activities that can help to change eating habits and level of physical activity. We also plan to
make use of the media such as Facebook, Twitter, radio and or TV announcements. In the
beginning of our intervention, we will use the pamphlets because they are easy to access by our
target population. We will place them in accessible locations such as doctors’ offices,
community centers, post offices, markets, churches, and in other places, where Hispanic
population gathers.
Using our intervention, we want to increase the awareness of target population about the
potential risk of diabetes on their health. We also want to help pre diabetics individuals to
understand the importance of healthy eating habits and daily physical activity. We want to
increase the knowledge about the causes of diabetes and ways to eliminate them. We want to
inform our target population about early symptoms of diabetes, so it will help target population
to find medical help if needed.
Health communication is a great resource for the dissemination of health information to
any target population. we will use pamphlets and social media for this specific program. It will
help the target population to receive our message quickly and use the provided information when
they need it.
Below is the pamphlets we are using in our health education strategies. The first page is
the outside of the pamphlet in an English version. The second page is the inside of the pamphlet.
The Third and four are in Spanish versions outside and inside respectively.

Health Education Pamphlets

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 Health Education Strategy

The objective of the health education promotion is to educate the Hispanic population in
El Paso, Texas, by informing them of the different types of diabetic, the risk, and what to do in
case of emergencies. We will use the inter and intrapersonal level of influence as we pretend our
target population and those that influence them to modify their health behavior.
With the use of SR theory alone with the HBM and ELM theory, we want the target
population to modify their health habits, engage in more activities and know alternatives, and
better option when talking about food. By using these theories, we will encourage this
modification at a gradual but steady pace.
Studies have demonstrated that the lack of information and education of our target
population has contributed to a higher incidence of diabetic among the Hispanic population in El
Paso, Texas. With the use of the health education strategy and the presentation of a short

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workshop, we plant to educate the target population to be more aware of the risk it represents to
have diabetic, and we look to modify their health habits as well.
The following is the plan of the workshop we plan to implement in our program. Again, it
looks to educate and inform the target population of the different types of diabetes, what causes
it, the symptoms, and how to help in case of emergency.
This workshop along with other components of our program will begin on January 2020
first with the information about diabetes (pamphlets, Spanish and English), with the first
workshop the first Saturday of January and subsequently, each Saturday of each month, for the
first six months to re-evaluate how the program is working. At the site medical assistant will be
available the third Thursday of each month January to June as well as a dietitian who’s going to
be available the fourth Friday of each month. We plant to use the LDS chapel to conduct our
presentation, measurement and nutritional advice

Diabetes Prevention Workshop

Understanding and Learning About Diabetes

Understanding and learning about diabetes

Objective: To increase Hispanic's awareness about diabetes, inform of better nutrition
options, and increase the interaction between Hispanics with their primary care provider.
Workshop one: What is diabetes – Know your blood sugar level: Definition Type 2 diabetes;
Diabetic Emergencies – What to look for; Treatment of diabetes – How can relatives help?
Lesson Plan
Objective: To understand Type one and Type 2, understand what Gestational diabetes is and
how to recognize and manage diabetic emergencies.
Introduction: Brief introduction of the class instructor and another program personnel present at
the workshop. Brief review of lesson plan (5 minutes).
Experience with diabetes: Have attendees share experiences they have had themselves or with
family members or friend having diabetes (10 minutes)
Key points
-Diabetes is a prevalent disease, and the majority of people’s lives have been affected in some
way by the disease.
-Most of the experiences have likely been with adults, but children are also affected by this
disease.

What do you know about Type 2 diabetes? (10 minutes)

(Review definition of each type, and why to know and understand the difference between these
two types of diabetes is essential. Pamphlet: What do you know about diabetes?)
Key points
-Type 2 diabetes is associated with family history, being overweight, and lack of exercise.
How diabetic affect Hispanics (10 minutes)

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Key points
-Explain the consequences of diabetes within the Hispanic community
-Explain what the most common diseases are related to diabetes
Diabetic emergencies: What should you know to be prepared, when should you be
worried? (11 minutes) Review Type 2 Diabetes emergencies.
Key points
-Diabetic emergencies are caused by either too much sugar or too little sugar
-Know the symptoms of each type
-Severe hypo or hyperglycemia requires immediate attention.
Treatment of diabetes – How can relatives help? (10 minutes)
Healthy Food Guide/ How much you should eat? (10 minutes)
Type 2 Diabetes: the body cannot properly use insulin or a failure of the body to respond to
insulin. Exact causes are unknown, but you are at high risk if: you are older, have a family
history, being overweight, race/ethnicity, and lack of regular exercise. Most cases can be
prevented. Does not cause symptoms early.
Symptoms: same as those in Type 1 diabetes, tingling, pain, or numbness in the hands and feet,
Itching and yeast infection, patches of dark skin.

Period open for questions: (5 minutes but if the audience is very engaged allow extra time 10
minutes max)
Hispanic/Latino American chance of being diagnosed with diabetes is more than 50%,
and Hispanics are more likely to develop this illness at a young age. Diabetes brings serious
complications later in life such as renal (kidney) failure, diabetes-related vision loss, and
blindness. Nerve damage known as neuropathy, high blood pressure, and strokes. Knowing and
understanding where you stand when diagnosing with diabetes can help you prevent this and
other symptoms related to diabetes.
Diabetic Emergencies/ what to do?
Diabetic emergencies are caused by an imbalance between the amount of sugar and the
amount of insulin in the blood. Hypoglycemia (low blood sugar) – Need sugar
Symptoms: weakness, faintness or hunger, confusion and irrational behavior, sweating
with cold, clammy skin, rapid pulse, trembling, deteriorating level of response
Causes: Receiving too much insulin, not eating or drinking enough, overexertion (too
much exercise), certain medication such as quinine, some medical conditions such as hepatitis or
kidney disease, a tumor that produces excess insulin, endocrine disorder such as adrenal gland
deficiency

What to do?
Very low blood sugar is a medical emergency. If someone you know has diabetes and
they are experiencing mild to moderate symptoms, have them eat or drink 15 grams of easily

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digestible carbohydrates, such as: half a cup of juice or regular soda, 1 tablespoon of honey, 4 or
5 saltine crackers, 3 or 4 pieces of hard candy, 1 tablespoon of sugar.

Hyperglycemia (high blood sugar) – Need insulin

Symptoms: excessive thirst, increased urination, blurry vision, fatigue, nausea/vomiting,
deep/rapid breathing, loss of consciousness/comma
Causes: not taking insulin, excessive food intake (carbohydrate intake), being less
physically active, being ill or having an infection, high level of stress.
What to do?
Proper diabetes management and careful monitoring of your blood glucose are both very
effective means for preventing hyperglycemia or stopping it before it gets worse. Get medical
advice and keep monitoring your level of sugar. Know how many carbohydrates you’re eating at
each meal and snack. Strive to stay in the amount approved by your doctor or dietitian. Keep this
information with your blood sugar levels.
Treatment of diabetes – How can relatives help?
In most cases, prevention is a critical factor in helping manage diabetes. Family members
can help by being supportive of that suffering from diabetes. You can also help your relatives to
make healthier changes; this will help your relatives manage their diabetes.
Avoid buying food that your relative is not supposed to eat. Although you are not
diagnosed with diabetes, adopting healthy eating habits will help you and your family members
be healthier. Eat foods that are low in fat, cholesterol, salt, and added sugar. Choose a variety of
fresh fruits and vegetables, whole grains, lean meats, and fish.
Encourage exercise and find time to exercise together. You can start by walking around
the block, dance or even engage in small activities at home like mopping, sweeping, or dusting
around your house. Do not forget to consult with your doctor what type of exercise is more
appropriate for your relative.
Another important thing you can do to help your relative is to know and recognize the
symptoms of low or high blood sugar; this can save the life of your relative. Understand that
when your relative is moody is because his/her blood sugar is out of range. Any symptoms of
high or low blood sugar should be a sign to seek medical attention. Know your relative’s health
care team and feel confident to talk to them.
How Much Should You Eat?
The amount of food you need to eat each day varies with age, sex, high, and activity
levels. Having diabetes does not mean you cannot eat the food you enjoy. You can keep eating
the foods you like. Just make sure to include lots of nutritious, healthy choices. Healthy,
nutritious choices include whole grains, legumes (dried beans, peas, and lentils), fruits,
vegetables, non-fat or low-fat dairy, and lean meats, such as fish and poultry. These foods are
high in vitamins, minerals, fiber, and lean protein, and low in saturated fat, cholesterol, and
refined sugar.

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 Eating carbohydrates affect your blood sugar more than other foods. The more you eat,
the faster and higher your blood sugar will rise. Eating fat and protein can affect how quickly
your body turns carbohydrates into sugar. When you know the amount of carbohydrates, protein,
and fat you are eating at a meal, you can learn to choose foods that help to keep your blood sugar
levels even.
The total amount of calories you eat every day is also essential. Eating the right amount
of calories will keep you at a healthy weight or help you lose weight if you need to. When you
eat is as important as how much you eat. When you have diabetes, your body is not able to adjust
the amount of insulin that goes into your bloodstream in response to what you eat. Eating the
same amount of carbohydrate at the same time every day can help you keep your blood sugar
levels closer to normal.

Most diabetes medicine helps your body use up sugar. Every time you take diabetes pills
or insulin, you need to make sure you time the amount of carbohydrates you eat. If you don't eat
enough carbohydrates at the right time, diabetes medicine can cause your blood sugar to drop. If
you eat too much carbohydrate at the wrong time, you might not have enough diabetes medicine
in your body to keep your blood sugar level close to normal. In that case, your blood sugar will
get too high. Your doctor can tell you how much carbohydrate to eat to match the medicine you
take and how to time your meals with your medicine.

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 Behavior Modification
In our program of prevention diabetes, we will use Behavior Modification Activities
strategy which influence interpersonal level. We will use Social Cognitive Theory with its
construct: Behavior capability, expectations, expectancies, self-control/ self-regulation, self-
efficacy, collective efficacy, emotional-coping responses, reciprocal determinism, and locus of
control. This theory states that reinforcement contributes to learning, but when it is combined
with an individual's expectations of consequences of behavior, it can determine the behavior. In
other words, using the construct of this theory we will:
- Increase our priority population’s awareness of diabetes (Behavioral Capability).
- Help people to think about diabetes as a potential threat to their health (Expectations).
- Help people to think about the value of their health (Expectancies).
- Help people to gain control of their own behavior through monitoring and adjusting
(Self-regulation, Self-control).
- Help people to feel confident that they can do certain things (like eating healthy food and
exercise) on a regular basis no matter what the circumstances (Efficacy expectations).
- Help people to believe that outcome of new behavior will be beneficial to them (Outcome
expectations).
- Help people to find support groups among families, friends or other participants that can
support behavioral changes (Collective efficacy).
- Help people to deal with sources of anxiety that may surround the behavior (Emotional-
coping response).
- Help people to understand that they can shape their environment to make behavioral
changes happen (Reciprocal determination).
- Help people to gain positive attitude towards changing behavior, so they would be able to
act for themselves in the future (Locus of control).
Description of the behavior modification activities.
Invited specialist will perform several steps for behavioral modification activity.
Medical assistant of local community clinic will perform weight measurement and fat
percentage measurement using Omron body composition monitor and scale and calculate Body
Mass Index. Also, the professional will take blood from the finger to measure blood sugar using
blood sugar tester. These results will be written in individual card of the participant.
Dietitian consultant of local community clinic will ask participants to write a journal
where they will indicate food intake each day during the week using the instructions on this
journal. Journals will be provided for each participant. Dietitian will help each participant to
install Exercise App on their cell phones, so they can measure their daily physical activity by the
quantity of steps they made during the day. This result will be written in their food intake journal
daily.
After one week of writing the journal, dietarian will provide thoughtful feedback for each
participant for 15 minutes. Schedule of the appointment with a dietitian will be provided. Invited

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health educator will perform a presentation for a group of participants (20-30 people) about
causes, symptoms and complications of diabetes. After the presentation we may perform five
minute written survey to identify the quality of knowledge of diabetes people gained during these
activities; the participants can sign up for other activities which will help them to increase the
awareness of causes, symptoms and complications of diabetes.
The data collected during these activities will be used for analysis and creation of
different interventions that can help to increase the awareness of priority population of causes,
symptoms and complications of diabetes. We may share this data with local community health
care organizations, so they can be aware of the percentage of people who are interested about
diabetes. This information will help healthcare providers to perform their own interventions.
This intervention helps to increase the awareness of causes and symptoms of diabetes. It
will help people to recognize if they have these causes in their life and discover ways to
eliminate them. This intervention will help the target population to recognize early signs of
diabetes, so they can receive early medical help and treatment. Moreover, it will the target
population to feel more confident in their ability of changing their behavior, so they can prevent
diabetes and remain healthy.

Test/Result Sheet

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Example of daily journal

Instructions of use of daily journal:

1- Write the time when you consume your food (breakfast, snacks, lunch and dinner)
2- Write every item (food and drinks) you consume during your breakfast, snacks, lunch and
dinner)
3- Write portion size of every item you consume. (Example – pizza – large piece, coca cola – 8
oz can)

4- Mark how many glasses of water you drink today (Example

5- Write how many steps did you do today according your Exercise App (Example, 4345 steps)

Calendar of Intervention

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