Racial and Ethnic Approaches to Community Health

Reach 2010

Purpose:

To eliminate racial and ethnic health disparities for more than 13,000 African-Americans with diabetes in Charleston and Georgetown counties in South Carolina

Target Population:

African-Americans with diabetes in Charleston and Georgetown counties

Program Goals:

• To improve health outcomes

• To increase access to care

• To generate funding for the continuation of coalition activities

• To empower the coalition

• To increase community awareness

Years in Operation:

2000 – 2008

Results:

The coalition found the following outcomes using the logic model:

• Increased attendance at annual testing for at least 13,000 African-Americans: an increase in kidney testing from 13 percent to 53 percent and foot exams from 64 percent to 97 percent

• Improved diabetes control (HbA1C <7 percent) from 11 percent to 48 percent for 13,000 African-Americans

• Improved adherence to American Diabetes Association guidelines for diabetes education, with teaching provided at 94 percent of visits, up from 41 percent

• Decreased emergency room visits (about 50 percent less) for unfunded persons with diabetes

• Decreased lower-extremity amputations in African-American men (from 80 per 1,000 hospitalizations to 31 per 1,000 hospitalizations)

• Community support for funding diabetes supplies and medication for uninsured people

• Improved community education for persons with diabetes

Funding:

Funding is generated by community fundraising, coalition activities, and an agreement from the Centers for Disease Control and Prevention.

Key Partners:

Alpha Kappa Alpha (Omnicron Rho Omega Chapter); Carolinas Center for Medical Excellence; Charleston Diabetes Coalition; Commun-I-Care; Diabetes Initiative of South Carolina; East Cooper Community Outreach; Franklin C. Fetter Family Health Center; Georgetown County Diabetes Group; S.C. State Budget and Control Board; the Diabetes Prevention and Control Program of the S.C. Department of Health and Environmental Controls (DHEC); S.C. Budget and Control Board; S.C. DHEC Regions 7 (Charleston) and 5 (Georgetown); South Santee St. James Community Center; Tri-County Black Nurses Association; various churches, community centers, worksites, libraries.

What Works and Why:

The coalition works to decrease disparities through community-based participatory research and service learning. However, much of its success is attributed in part to a clear articulation of the principles of community-campus partnerships and of community-based participatory research, as well as working with honest communication and issue identification. Another factor that has supported the coalition's success is clearly identified and prioritized goals and objectives and community support for reaching the identified milestones.

Structure and Operations:

The Charleston and Georgetown Diabetes Coalition is a partnership between the Charleston and Georgetown communities and the Medical University of South Carolina College of Nursing. It is an urban-rural, community-university diabetes coalition, working in partnership to eliminate ethnic health disparities for more than 13,000 African-Americans with diabetes in Charleston and Georgetown counties in South Carolina. Local community groups, health care professionals, and people with diabetes identify assets and implement and evaluate community actions.

Decisions are made through a democratic process, with each group getting one vote. Local coalitions in each county are governed by a board and bylaws. At each meeting (quarterly or monthly), they assess some aspect of their progress, and they use continuous quality improvement processes to move toward their mission and goals.

Barriers to Success:

One of the major barriers to the success of REACH 2010 in Charleston and Georgetown counties is the participation of the target population in the program. Working with such a large target audience is difficult when trying to attain the predetermined goals.

More Information:

http://reach.musc.edu/index.html

Download:

Download this program information in PDF format.