Pacific Union Recorder

New research conducted by Loma Linda University School of Nursing professors is helping to uncover the growing burden of diabetes in the United States.

Edelweiss Ramal, Ph.D., R.N., assistant professor of nursing, School of Nursing, presented the initial findings of her research, titled "Barriers to Diabetes Self-Care Management in Latinos in San Bernardino, California," at the Global Conference on Health and Lifestyle in Geneva, Switzerland, in July 2009.

Ramal's study qualitatively identified barriers to lifestyle changes that promote self-care management in Latino diabetic persons. These are individuals who have been referred to and/or attended part or all of the diabetes classes at SACHS-Norton Clinic in San Bernardino.

According to Ramal, the escalating rate of diabetes among Latinos is alarming.

"The incidence of diabetes is increasing dramatically in the community of San Bernardino," she says.

Latinos represent the largest ethnic group (46 percent) in San Bernardino (U.S. Census Bureau, 2006). A group of master of public health degree students conducted a needs assessment at a local clinic for this at-risk group. This was followed up with observations made by the investigators while conducting diabetes classes among this population. Both interactions indicate the need for a contextualized lifestyle approach to diabetes management.

"We want people to learn to control their diabetes," says Ramal. "It requires a change in lifestyle that is often difficult. This includes building a support group and other activities so that they don't feel isolated."

Data was obtained over 12 months by audio taping focus group discussions of two to eight participants per group, with a total of 30 to 40 participants. The discussions were guided by a theory-based protocol and moderated by the investigators. The data was transcribed for analysis without associating personal information of participants other than general data, such as venue of focus group, date, total number of women and men, age range, and number of classes attended.

Ramal hopes that their research can improve diabetes education for this at-risk group.

"Our findings show me that we need to dig deeper and continue this research," she says.

Previously, the clinic offered individual education for adults and children as part of its health education services. These services include information on hypertension, lipid management, weight management, and general nutrition. The education classes help to improve the level of diabetes self-care related to lifestyle. The group is also currently in the planning stages to begin teaching courses at La Escuelita, a project of the LLU Community-Academic Partners in Service program, in order to benefit members of the community who may not be clients of the clinic.

The educators have also added meal planning and food demonstrations with a high-fiber, low-fat, plant-based diet as part of the program.

Ramal is excited about the future of this program and is currently working on an article about the  findings, in addition to a research grant.

"I  have always had a passion for educating others on diabetes and diabetes management," she says.