I have drafted a powerpoint presentation. I need 4 slides added that address the gaps in healthcare as it pertains to diabetes in low income women in the Highbridge/Concourse community and propose culturally competent evidence-based interventions from 2 additional professional literature. Also the existing powerpoint is edited, content reduced to look good but covering the following criteria:

Described population group then described the population’s health problem providing data to support.

Describe the gaps in healthcare How does this project fulfill one arm of the mission of public health: social justice? How does it contribute to social change?

Described results of comprehensible community assessment showing collaboration with health care team members and or individuals/groups that represent the problem. Developed possible evidence-based culturally competent interventions/programs aimed at primary prevention at the community and system level of care specific to community.

Chose a possible way to evaluate outcomes of project

Described role as a health care leader in community Discuss your role as an advocate and health care leader in promoting positive social change as a scholar-practitioner to improve the health of vulnerable populations in your community

Diabetes in Hispanic Women

Highbridge/Concourse Community

Statistical Data

There are approximately155,835 people living in this community, of which 65% are Latino, 31% are black, 2% are Asian, 1% is white and 1% are of some other ethnicity group.
The community is inhabited by 29% of young adults in the age range of 25-44, 27% of the residents are in the age group of 0-17 and 23% are in the age range of 45-64
The denial of resources and opportunities has contributed to the current disparities seen in the health outcomes in the Highbridge and Concourse community.
Over % of patients in withing the New York have diabetes
17 % of patients within the Highbridge/Concourse Community have diabetes compared to 3% in the Financial District/Greenwich village area of NYC

(NYC Department of Public Health, 2018).

Determinants to Health
Access to Healthy Food- 1 supermarket to 18 bodegas in this community, numerous fast-food restaurants
Education-. In a study of a diverse group in a southern community, diabetes incidence tended to decline as both education and income levels rose (Conway, 2018).
Language Barrier- ), 42% of the individuals in this community were born outside of the United States and 35% have limited proficiency in English.
Income level – % of families in this neighborhood live in poverty . According to NYC Department of Public Health (2018), 32% of people in the community live in poverty compared to 20% in NYC and unemployment rate is 13% in this area
Access to healthcare- uninsured, childcare issues, affordability, transportation, inflexible work schedule

Gaps in healthcare

Culturally competent Intervention: Use of Technology to control gylcemic levels in Hispanics
One evidence-based, culturally competent behavior change that would promote health for the Hispanic population with type 2 DM in this community is the use of technology. Studies found that Latinos can effectively use technology tools to improve health behaviors such as physical activity (Rosas et al., 2018).  Apps such as MyFitnessPal and Fitbit activity tracker were useful among middle-aged Latinos.  As noted by Ashrafzadeh & Hamdy (2019), smartphone application incorporating blood glucose readings transmitted from patients’ glucometers, manual dietary tracking, exercise tracking by a fitness tracker, diabetes education, and capacity to communicate with healthcare providers resulted in HbA1c reduction by 0.6% in 12 weeks of intervention. These findings suggest that technology can improve patient self-management in diabetes control and enhance the delivery of care in prediabetic and diabetic patients

Culturally Competent Intervention: Dietary change
Most of the foods are high in fats and calories, family celebrations may involve pressure to overeat and turning down food can be viewed as impolite (CDC,2019). Some view overweight as being healthy

Culturally competent Intervention: Diabetic Education
Educational material for the people in this community need to reflect their culture, diverse languages, food preferences and educational level. Recommendations given to improve health should consider the income level of the community.

Community Resources
Lifestyle medication program
Diabetic Education Class
the Bronx Health REACH/ Institute for Urban Family Health- coalition that help individuals within the Bronx neighborhoods to change their knowledge attitudes and behaviors about health and healthy lifestyle
Lincoln Medical and Mental Health Center
6 Elements of Fitness- family gym in the south Bronx
Farmers Markets and $2 Farmers Market Health Bucks

Outcome can be measured by:
Improved glycemic control as reflected by lower HGB A1C
Weight Reduction
Healthier eating habits
Increased physical activity

Role as a healthcare leader in the community
Assess the population
Identify determinants of health and gaps in healthcare
Collaborate with community leaders, healthcare facilities and professionals
Implement interventions in a community that are culturally competent
Evaluate the effectiveness of interventions to ensure positive health outcomes
Advocate for culturally appropriate resources that will assist people in making healthier choices and support diabetic patients in meeting their goal of achieving glycemic control.

References
References
Baqiyyah N Conway, Xijing Han, Heather M Munro, Amy L Gross, Xiao-Ou Shu, Margaret K Hargreaves, Wei Zheng, Alvin C Powers, & William J Blot. (2018). The obesity epidemic and rising diabetes incidence in a low-income racially diverse southern US cohort. PLoS ONE, 13(1), e0190993. https://doi-org.ezp.waldenulibrary.org/10.1371/journal.pone.
Devia, C., Baker, E. A., Sanchez-Youngman, S., Barnidge, E., Golub, M., Motton, F., Muhammad, M., Ruddock, C., Vicuña, B., & Wallerstein, N. (2017). Advancing system and policy changes for social and racial justice: comparing a Rural and Urban Community-Based Participatory Research Partnership in the U.S. International Journal for Equity in Health, 16(1), 17. https://doi-org.ezp.waldenulibrary.org/10.1186/s12939-016-0509-3
New York City Department of Public Health. (2018).  Community Heath Profiles 2018, Bronx Community District 4: Highbridge and Concourse. Retrieved from https://www1.nyc.gov/assets/doh/downloads/pdf/data/2018chp-bx4
https://www1.nyc.gov/assets/doh/downloads/pdf/cdp/cdp-resource-sobronx
Shervin Assari, Maryam Moghani Lankarani, John D. Piette, & James E. Aikens. (2017). Socioeconomic Status and Glycemic Control in Type 2 Diabetes; Race by Gender Differences. Healthcare, 5(4), 83. https://doi-org.ezp.waldenulibrary.org/10.3390/healthcare5040083Yee, L. M., Leziak, K., Jackson, J., Niznik, C. M., & Simon, M. A. (2020). Health Care Providers’ Perspectives on Barriers and Facilitators to Care for Low-Income Pregnant Women with Diabetes. Diabetes Spectrum, 33(2), 190–200.