Border Health Strategic Initiative

To confront the threat of diabetes on the U.S.-Mexico Border, representatives from border communities in Yuma and Santa Cruz Counties joined the Mel and Enid Zuckerman College of Public Health (MEZACOPH) to develop and test a comprehensive and sustainable model for community-oriented chronic disease prevention and control.  Launched in October 2000, the Border Health Strategic Initiative (Border Health ¡SI!) model promoted individual prevention and control, while assisting communities to develop system-level strategies that support healthy
behaviors.  Central to the model’s success were promotores de salud, who not only provided services to individuals, but also engaged community members in addressing the health of their environment.  Border Health ¡SI! was a true collaboration between community and academic partners.

The former understood the needs and local issues of their community. The latter brought technical expertise in intervention design and evaluation.  The synergy provided an energizing and inspirational experience for all involved. The vision of Border Health ¡SI! was to create a comprehensive chronic disease prevention and control model that will have the greatest impact on a community over an extended period of time.  To realize this goal, the project operated under a set of guiding principles outlined below.

• Comprehensive: addresses multi-levels of prevention.

• Community-Oriented: strategies developed within the community.

• Acceptable to stake holders: involves community partnerships.

• Effective in fostering and sustaining change: strategies involve individual skill building and support.

• Evaluation: rigorous scientific assessment of processes and outcomes of change.

• Transportable: adaptable to other communities.

• Sustainable funding.

Under these guiding principles, Border Health ¡SI! encompasses a series of objectives or project components that comprise our goal toward a comprehensive and systems change approach to chronic disease.

Border Health ¡SI! programs:

1. Special Action Groups – Help community design and implement policy.

2. Patients – Increase the extent and efficacy of patient diabetes self-management through self-management, skill-building and patient-empowerment.

3. Providers – Work with health care providers in community health centers to evaluate and improve the quality of their diabetes care.

4. Families – Increase the range of primary prevention and diabetes support behaviors of family members of identified persons living with diabetes.

5. Community – Increase primary prevention behavior among community members through improved nutrition and increased physical activity.

6. Schools – Assist elementary and middle school to develop policy related to school-based nutrition and physical activity.

Guiding Principles:

• Comprehensive

• Community-Oriented

• Acceptable to stake holders

• Effective in fostering and sustaining change

• Evaluation: rigorous scientific assessment of  processes and outcomes of change

• Transportable: adaptable to other communities

• Sustainable post funding