Community-based Settings

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Community-based interventions usually involve a number of different strategies and activities aimed at creating changes in the knowledge, attitudes, beliefs, and skills that influence health. One of the unique features of community approaches is that they typically include strategies to create change in individuals and families as well as efforts to change organizational and environmental factors and policies that influence behavior and health. These programs are designed to prevent diabetes through interventions to support lifestyle changes to reduce weight or improve overall health and to manage diabetes through interventions to monitor glucose levels, regulate glucose through medication, and promote regular contact with health care providers.

Community-based interventions include strategies that are implemented in a variety of places with a variety of partners including:

counties metropolitan areas Native American reservations and villages African American communities Latino communities community centers conference centers health departments states

clinics pharmacies hospitals medical centers schools (elementary, middle, and high school) diabetes education centers neighborhood organizations churches camps (e.g., American Diabetes Association Diabetes Camp

Previous work in community-based settings has found:

• Community health centers can reach low-income and racially diverse residents to provide diabetes education interventions.
• Children spend many hours after school at community organizations (e.g., boys and girls clubs). Community-based settings provide an alternative to schools and allow for the tailoring of programs to each individual child. In these settings, children may work on goal setting and skills building to decrease their risk of developing diabetes or improve diabetes management.
• Community and leisure time settings for diabetes interventions can provide support, motivation, and reinforcement for behavior change learned in other settings.
• Retirement villages can incorporate health activities into their social events to encourage diabetes management among the older residents.
• Summer camps are an ideal setting for diabetes interventions given their friendly atmosphere that encourages shared feelings, problems, and ideas; assistance in helping the child achieve acceptance of the condition; opportunities for children to become autonomous and master their condition; and opportunities for interactions between parents, health care providers, and children.
• The supermarket is especially suitable to influence behaviors because it is a point of choice setting that can provide individuals with information, reminders, recommendations, prompts and reinforcements to perform certain behaviors as part of a healthier lifestyle.
• Restaurants can serve as an important setting for nutrition education components of diabetes education programs by advertising in their menus which items are nutritious choices.
• It is important to establish legitimacy for diabetes interventions in the community as a community project and not an experiment.
• In community or organizational settings, intervention strategies often include informational support (information about diabetes), tangible support (skills and abilities people have to prevent or manage diabetes) and appraisal support (sense of acceptance and belonging as individuals make choices to change diabetes-related behaviors).