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Zarmine Naccashian, PhD, GNP, RN,CDE Assistant Professor, CSUN
Felicitas A. dela Cruz, RN, DNSc, FAANP Professor and Director, APU
Center for the Study of Health Disparities
To describe the risk factors of Armenian Americans (AA) in Los Angeles for hypertension (HTN) and diabetes mellitus (DM). Specifically, it sought to: measure their height, weight, blood pressure (BP), lipids, blood sugar, waist and hip circumferences; and identify their risk factors for HTN& DM.
Armenian Americans (AAs) were among first Europeans to come to America in 1618(Mirak, 1983)
Influx of Armenian immigration incremental relative to political situation in the countries of origin, starting early
19th century
Currently, over ½ million Armenians live in LA (Papazian, 2001)
Seldom studied as a group, called hidden minority (Rollins, 1981)
No data are available on health risks of AAs in general, on prevalence of chronic diseases such as HTN and DM
Research design: descriptive (cross-sectional) Setting: Glendale Health Festival
in Glendale, CA
Sample: 272 AAs who attended the community health fair in November 2011
Data collection: Volunteer, trained AA, RNs, members Arm.Amer.Nurs.Assoc.(AANA) measured/tested participants height and weight waist and hip circumferences blood pressure (BP), lipids and blood sugar
Sex and Age of AA Participants SEX •Male = 84 (31%) •Female= 188 (69%)
MEAN Age=53 (SD=13.46)
Age Frequency Valid % <30 23 08.5 30-39 21 07.7 40-49 49 18.1 50-59 87 32.1 60-69 70 25.8 70-79 18 06.6 80-89 3 01.1 Total 271 100.0
Weight BMI Freq % Underwt <18.5 2.9
Nl wt 18.5-25 069 25.4 Overwt 25-30 086 31.6 Obese >30 106 39.4
Missing 003 01.1 Total 272 100
BP BP Freq % Normal <120/80 105 38.6
Low Pre-HTN 120-129 37 13.6 High Pre-HTN 130-139 60 22.1
HTN >140/90 67 24.6 Missing 003 01.1 Total 272 100
Sex
Reference Circumf Mean SD Variance Range
Male (n=84) <40”(91cm) Waist 39.67 7.85 61.85 27-88
Hip 41.73 4.20 17.71 33-63
Fem (n=188) <35” (80 cm) Waist 36.54 5.62 31.68 24-59
Hip 43.85 23.5 553.6 22-355
Waist/Hip Reference Mean SD Coeff Disper
Range
Men <0.90 0.99 0.15 0.072 0.69-2.17
Women <0.85 1.03 0.09 0.069 0.075-1.31
Glu level Reference Freq % bld gluc <60 1 0.40 Normal 60-100 149 54.8 Pre-DM 101-125 77 28.3
DM >126 44 16.2 Missing 01 0.40 Total 272 100
HDL Refere Freq % High risk <40 83 30.5 Optim level >40 124 45.6 Protect level >60 54 19.9 Total; 272 100
LDL by Refer Fre % Opt LDL <70 60 22.1 Near Opt LDL <100 72 26.5 Border High >130 59 21.7 High >160 29 10.7 Very High >200 15 05.5 Missing 37 13.6 Total 272 100
Trig Reference Freq % Optimal <150mg/dl 101 37.1 High Risk 150-200 57 21.0 High >200mg/dl 112 41.2 Missing 02 0.7 Total 272 100
Category Reference Freq % Desirable <200 102 37.5 risk 200-240 102 37.5 High >240 67 24.6 Missing 01 0.4 Total 272 100
Over a third had pre-HTN Over a fourth with HTN Nearly ¾ exceeded normal BMI Nearly half had pre DM or DM Slightly over 2/3 had high total cholesterol (TC) and triglycerides
Anthropometric & laboratory measures revealed substantial percentage of AAs manifesting risk factors for HTN & DM Importance of incorporating waist/hip measurements at each clinic visit
Health fair is effective venue for: ◦Identifying risk factors & case finding ◦Health promotion & disease prevention counseling ◦Channeling uninsured attendees to community clinics for primary care delivery needs
Goal: ◦ Reaching out the uninsured
Planning Committee: ◦ Multidisciplinary ◦ Representatives from City officials
Providers: ◦ Multidisciplinary
Supporters: ◦ Financial
Providers Medical Dental Optometry Nursing Students Referral
Supporters Hospitals Pharm. Co Businesses Non-Profit
Physicians and dentists: ◦Members of the Armenian Medical Society ◦ Local providers:Hospitals in Glendale Advertised via hospital medical staffing office Advertised on FB ◦ Provided: screening, consultation, service ◦ Referral to community clinics
Optometry: ◦ Lion’s Club
WMMC Cancer Registry: ◦ Provided mammogram ◦ Pap test
GAMC Cancer Registry: ◦DRE ◦ PSA
Nursing: ◦ Members:Armenian American Nurses Asso ◦ POCT: Blood lipids, glucose ◦ BP measure ◦ BMI measure ◦ Flu shots through Health Dept. ◦ Education
Referral: ◦ Comprehensive Community Health Center ◦ All for Health, Health for All ◦ QueensCare
CLIA waived license License obtained via Health Dept. with fee
Machines Cholestech LDX Order 300 cassettes or more, get one free
machine (Henry Sheine distributor) Borrow from other clinics
Supplies:
Hospitals ◦ New service/dept. represented
Pharmaceutical companies ◦ Grant money
Businesses ◦ Home Health ◦ Adult Health Day Care Centers
Organizations ◦ Armenian Relief Society (social issues) ◦ LA County Office of Women’s Health
Collaborative work with health care providers Exploring social/health issues/problems Serving community Allowing students opportunities to do
volunteer work or gain community outreach clinical practice hours.
Analyzing data to identify extend of health problem and plan interventions accordingly.