Abstract: “Lifestyle Champions” for a Localized Pre-Diabetes Awareness Campaign

◆ Sarah Aghazadeh, University of Maryland
◆ Linda Aldoory, University of Maryland

National diabetes prevention campaigns often fail to connect with underserved populations when they overlook some unique needs and lived experiences of local communities. Also, these campaigns often ignore pre-diabetes even though it is a critical time period when people can make lifestyle changes to prevent or delay Type 2 diabetes. Community based participatory research (CBPR) can address barriers to effective pre-diabetes communication by providing pathways for meaningful health message creation for target populations. CBPR is a collaborative approach to research that values equitable participation of audience members and researchers. Thus, CBPR acknowledges intersectional experiences of chronic disease, everyday life, and barriers to change. Using CBPR, we worked with a local community, created “lifestyle champions” among residents, and partnered with local groups to design health messages that increased awareness about pre-diabetes and local lifestyle change programs. We offer lessons learned from this pilot project in which researchers partnered with residents and groups to access community member feedback about messages, sources, and channels, and to steer localized efforts for a statewide pre-diabetes awareness campaign.
The U.S. Centers for Disease Control and Prevention (CDC) funded the pilot study. Goals of this pilot included: 1) increasing awareness/knowledge of pre-diabetes and diabetes risk, and 2) increasing self-efficacy for lifestyle changes among residents of Southern Maryland, and 3) promoting the CDC’s Diabetes Prevention Program. A county health department was a central partner for the pilot project: roughly 12.3% of adults in the county have diabetes, a rate higher than both the national and state averages. The county has some of the highest proportions of racial and ethnic minorities, immigrants, and Medicaid enrollees. These residents experience a range of health disparities and, while often aware of diabetes, almost wholly unaware of pre-diabetes diagnoses and lifestyle changes that can reduce their risks of developing diabetes. The pilot project considered the wide range of experiences and identities of target community members by looking to them to develop meaningful health messages.
The project demonstrated the process for and value of creating “lifestyle champions” among residents to help access groups such as local churches, civic associations, senior citizen groups, and community health organizations. The champions worked with researchers to provide outlets for resident feedback for message design, source, and channel selection. Researchers and residents together adapted CDC information into a toolkit of materials and then met with groups to consider effective, localized messages. Critical factors for this community included age, family obligations, food access, residence, income, and insurance. Details such as font size on printed materials, format/number of brochure pages, appeal, and level of risk emerged from conversations. Other characteristics of CBPR were implemented, including: building on the strengths and resources of the community; finding areas of mutual benefit for researchers and local champions; and giving up “power” and voice in order for champions to have agency in the process. Unexpectedly, this pilot also generated several new partnerships with community groups, which will help the county health department in future campaigns that will require a CBPR approach to design.