"Living well with diabetes": evaluation of a pilot program to promote diabetes prevention and self-management in a medically underserved community.

A substantial disparity exists in the prevalence and effective self-management of diabetes among African Americans in the United States. Community-level programs have the potential to affect self-efficacy and may be helpful in overcoming common barriers to self-management. The Neighborhood Health Talker Program used community members trained as cultural health brokers to engage their communities in conversations about "living diabetes well." Program evaluators used mixed methods to analyze post-conversation surveys and Health Talker field notes. These indicated an increase in diabetes-related knowledge and increased confidence among conversation participants. Conversations included discussion of barriers and facilitators to lifestyle changes and effective self-management that are frequently overlooked in a clinical setting.

Transforming community members into diabetes cultural health brokers: the Neighborhood Health Talker project.

PURPOSE: The purpose of this study was to evaluate a community-based diabetes education pilot project. The Neighborhood Health Talker project aimed to train and implement cultural health brokers primarily targeting communities of color to improve community members' diabetes knowledge and diabetes self-management skills. A secondary aim was to establish diabetes resource libraries accessible to communities that normally experience barriers to these resources. METHODS: Recruited community members completed 1 week of formal training developed by a multidisciplinary team in Buffalo, NY. The effect of training was evaluated through the use of baseline surveys, a pretest/posttest covering all training content, and daily quizzes evaluating knowledge relevant to each of the five training modules. Trained NHTs then held at least five community conversations in various locations and administered anonymous postconversation surveys to participants. Descriptive statistics and qualitative analysis techniques were used to summarize test, quiz, and survey results. RESULTS: Twelve women and 1 man completed the training program. Working alone as well as in pairs, each held at least five community conversations reaching over 700 community members of all ages over 3 months and established 8 diabetes resource libraries in the community. All trainees increased their diabetes knowledge and confidence as well as their abilities to perform the tasks of a cultural health broker. Trainees also indicated that the goals they set at training initiation were met. CONCLUSIONS: The training was successful in increasing trainee knowledge and confidence about diabetes prevention and self-management. Participants not only developed proficiency in discussing diabetes, they also made important lifestyle changes that demonstrated their commitment to the cause and the project. Low-cost initiatives like this are easily reproducible in other communities of color and could be modified to meet the needs of other communities as well.

Computed NMR shielding increments over benzo-analogs of unsaturated five-membered ring heterocyclic compounds as a measure of aromaticity.

The GIAO-HF method in Gaussian 03 was used to calculate the isotropic shielding value of the proximal hydrogen of a diatomic hydrogen probe moved in a square grid 2.5A above the plane of 15 benzo-fused analogs of conjugated five-membered ring heterocyclic compounds: pyrrole, furan, thiophene, and phosphole and their 2- and 3-nitrogen analogs. Subtraction of the calculated isotropic shielding value of diatomic hydrogen from each of these isotropic shielding values gave the shielding increment (Delta sigma) for each probe position. Plotting this value against Cartesian coordinates of the probe position allowed determination of the computed through-space shielding increment surfaces for these compounds. Substantial shielding was observed above the center of each ring, as expected for aromatic compounds. The magnitude of the shielding increment 2.5A above the heterocyclic ring center correlated reasonably well with the only other published method of assessing aromaticity of these systems ASE (aromatic stabilization energy) and with our calculated NICS (nucleus-independent chemical shift) values, another magnetic criterion. The magnitude of the shielding increment measured over the benzene ring midpoint did not correlate well with other measures of aromaticity, however.

Computed NMR shielding increments over unsaturated five-membered ring heterocyclic compounds as a measure of aromaticity.

The GIAO-HF method within Gaussian 03 was used to calculate the isotropic shielding value of the proximal hydrogen of a diatomic hydrogen probe at various distances (2.5 A, 3.0 A and 4.0 A) above the plane of 15 conjugated five-membered ring heterocyclic compounds: pyrrole, furan, thiophene, and phosphole and their 2- and 3-nitrogen analogs. Subtraction of the isotropic shielding value of diatomic hydrogen by itself from each of these isotropic shielding values gave the shielding increment (Deltasigma) for each probe position. Plotting Deltasigma against Cartesian coordinates of the probe position allowed determination of the computed through-space shielding increment surfaces for these compounds. Substantial shielding was observed above the center of each ring, as expected for aromatic compounds. The magnitude of the shielding increment at 2.5 A above the ring center (Deltasigma(2.5)) correlated reasonably well with other established methods of assessing aromaticity, including geometric (HOMA, harmonic oscillator model of aromaticity), energetic (ASE, aromatic stabilization energy), and magnetic (NICS, nucleus-independent chemical shift) criteria.