- Characterizing Access to Healthcare
In the summer of 2016, we sought to determine how readily available healthcare resources were in the rural communities in which we held health fairs. The survey included questions about who had a primary care doctor and also questions about how diabetic patients managed their condition. We learned about the difficulties (e.g., lack of transportation, clinic hours) that made accessing medications for diabetes considerably challenging and that will also inform our future health fairs with these patients.
- Comprehensive Analysis of Oral Health Disease Burden
In the summer of 2016, PPS initiated a dental component to expand on a need for oral care observed by the previous cohort. We conducted a week long dental health fair in which we offered participants of all ages a survey to gauge what their oral health literacy level and access to dental care. We then conducted a limited oral examination checking for the participants' number of decayed, missing, and filled teeth. Afterwards, we offered oral health education regarding how to properly brush, how to floss, and how often to do each. For attendees with urgent needs, we referred them to the local dentists in Juventino Rosas.
- "Are We Helping?" - Qualitative Analysis of Student-Led Medical Outreach in Guanajuato, Mexico
PPS is a staple of UNC's international outreach programs, but prior to 2016, no one had done a formal review of the program. In the summer of 2016 we performed a mixed method analysis, including surveys and interviews to assess the strength and weakness of the PPS, as well as provide direction for future teams. In general we found that our efforts had been very well received and had made a substantial positive impact in the communities where we served. The area that needed the most improvement was student leadership and communication.
- Cardiovascular Disease
This summer PPS will be working to expand Cardiovascular health screenings in Juventino Rosas and San Miguel de Allende. The group will work with local residents to assess their cardiovascular health through questionares, BMI, blood pressure, and diet/exercise surveys. Heart disease is a leading cause of death in the Latino immigrant population in the United States and a rising cause of morbidity and mortality among source populations in Mexico. PPS has collected preliminary data from adults in Juventino Rosas which confirm that hypertension, hyperglycemia and obesity are of significant concern
- Sugar-Sweetened Beverages and Junk Food
In the summer of 2015, we plan to continue studying the effects of Mexico's federal tax on Sugar-Sweetened Beverage and Junk food. We will revisit the same communities in which we administered nutritional surveys in 2014, locating participants from last summer to readminister the survey and collecting their BMI. The survey includes questions about number of sodas and tortillas consumed daily, as well as junk food intake. Our survey will also ask about attitudes toward the soda and junk food tax. These questions will address the acceptability of the tax in addition to assessing whether or not the tax has affected their consumption of sodas and junk food. The survey will still include items about access to clean water since the proceeds from the SSB and junk food tax were supposed to go to improving water access
- MESA (Mujeres En Solaridad Apoyandose)
The migration of working-aged men from Mexico to the U.S. in search of economic opportunity has created unmet mental health needs in the women left behind. In Guanajuato, Mexico, depression rates are as high as 50% among women. In the summer of 2010, a public health intervention, the MESA Project (Mujeres En Solidaridad Apoyándose or Women in Solidarity and Support), was piloted in the community of Juventino Rosas, Guanajuato, using promotoras, or lay health advisors. Initial results suggest that MESA is an effective way to reach and help women in rural Mexico who suffer from stress and depression. In 2011, we expanded the project in Juventino Rosas, training leaders for seven new support groups using a revised curriculum and measuring changes in depression levels for women participating in the program. PPS team members also assessed the need for such an intervention in nearby San Miguel de Allende.
Poor vision can often be the cause of a poor education, and, down-the-road, a poor lifestyle. In the summer of 2012, we partnered with the Lion's Club of San Miguel de Allende to eliminate this threat via vision screenings and free corrective lenses. Additionally, we collected the vision data from children between the ages of 7 and 17 in concurrence with a food-frequency questionnaire to determine their level of dietary Vitamin D. The goal of this research was to examine the relationship between nutrition and myopia in rural Mexico. More data is still needed, but it is clear that myopia is prevalant in central Mexico.
Both in Juventino Rosas and in San Miguel de Allende, student groups will be issuing surveys investigating nutrition and other health practices. We hope to glean information on the state of nutritional health in Guanajuato that will inform highly specific and relevant future interventions.
- Obesity and Diabetes
By measuring BMI, body surface area, blood glucose, and HbA1C, students will collect data on the prevalence and severity of diabetes in San Miguel de Allende. Nutritional surveys issued will also investigate other health practices relevant to obesity and diabetes, such as physical activity, access to and use of health resources.
- Renal Disease
Students in San Miguel de Allende will be measuring early biomarkers of renal disease. Specifically, we will be screening for microalbuminuria in the rural regions outlying San Miguel. The presence of microalbumin in urine is an early indicator of renal problems which, if left untreated, can progress to end-stage renal disease, requiring dialysis and/or renal transplant. Diabetic and obese individuals have elevated risk of developing kidney problems, so this research goal goes hand-in-hand with our investigation of diabetes.
- Geriatric Health
These preliminary surveys also found that 92% of women surveyed reported no exercise outside of work of, and that 86% reported eating fewer than 3 fruits or vegetables per day. Having established the high prevalence of cardiovascular risk and unhealthy nutritional behavior in this population, PPS's next step will be to create intervention programs focusing on behavior modification. Diet and exercise, in particular, are two modifiable behaviors that will be targeted. The assessment of Cardiovascular health paired with these new interventional programs will create a comprehensive effort to improve Cardiovascular health in the people of rural areas of Guanajuato, Mexico.
December 2010 PPS Wins Student Research Poster Presentation Award at the NC Academy of Family Physicians 2010 Winter Conference
In 2010, we investigated the geography of nutrition in the small communities outside of San Miguel de Allende, Guanajuato amongst elementary school students by performing health fairs and nutritional surveys. We also investigated maternal attitudes towards obesity and undernutrition, finding that Mexican mothers tended underestimate their child's body mass index and value moderate obesity as a positive health sign. Lastly, we performed interviews with community members to base our future research and activities in the needs of the community.
See the award-winning poster 2010 here.
December 2009: PPS Wins Student Research Poster Presentation Award at the NC Academy of Family Physicians 2009 Winter Conference
Students from the Summer 2009 PPS group presented posters at the 2009 Winter Conference of the North Carolina Academy of Family Physicians in Asheville, NC. One poster, focused on the widespread perception among rural Mexicans of diabetes as the effect of a "susto" or "fright sickness," was awarded the Student Research Poster Presentation Award.
See the award-winning poster 2009 here.
- Perceptions of Diabetes in Rural Mexico: A Frightful Reality - Winner of the Student Poster Presentation Award at the NC Academy of Family Physicians 2009 Winter Conference, Asheville NC.
- Nutritional Behavior of Rural Mexicans: Not What You May Believe - Presented at the NC Academy of Family Physicians 2009 Winter Conference, Asheville NC.
- High Rates of Depression and Cardiovascular Risk Factors in Rural Mexico - Presented at the World Congress of Cardiology in Argentina
- Waist Circumference vs. Waist-to-Hip Ratio - presented at the Department of Family Medicine, UNC Chapel Hill
- Economic Migration and HIV Risk Factors
- Cardiovascular Health and Risk Factors