Current Studies: Proyecto Bienestar South San Antonio (PBSSA)

Published Research Articles

Below is a list of papers on SAHRC research projects.

  1. Diabetes Risk, Low Fitness, and Energy Insufficiency Levels among Children from Poor Families

    Roberto P. Treviño, MD; Donovan L. Fogt, PhD; Tammy Jordan Wyatt, PhD; Liset Leal-Vasquez, MA, RD; Erica Sosa, MS; Charlotte Woods, MPH
    Journal of the American Dietetic Association (08/08)

  2. NEEMA: A School-Based Diabetes Risk Prevention Program Designed for African-American Children

    Mary Shaw-Perry, PhD, CHES; Charlotte Horner, MPH, CHES; Roberto P. Treviño, MD; Erica T. Sosa, MS; Irene Hernandez; and Abhishek Bhardwaj, MPH
    Journal of the National Medical Association Vol. 99 NO. 4, April 2007

  3. Social Capital And Health: Implications For Working With Minority And Underserved Populations

    Robert P. Treviño, MD
    The Health Education Monograph Series, Vol 22, No. 1, 2005

  4. Effect of the Bienestar Health Program on Physical Fitness in Low-Income Mexican American Children.

    Hispanic Journal of Behavioral Sciences (2/05)

  5. Impact of the Bienestar School-Based Diabetes Mellitus Prevention Program on Fasting Capillary Glucose Levels.

    Pediatrics & Adolescent Medicine (9/04)

  6. Diabetes Risk Factors in Low-Income Mexican American Children

    Diabetes Care (2/99)

  7. Bienestar: A Diabetes Risk-Factor Prevention Program

    Journal of School Health (2-98)

  8. The Bienestar School-Based Program for Preventing Diabetes in Schoolchildren: An Interview With Roberto P. Treviño, MD

    Therapeutic Strategies in the Intervention of Coronary Events (12/05)

Current Studies:
Proyecto Bienestar South San Antonio (PBSSA)

In response to increasing rates of obesity and type 2 diabetes in children, the Blake, Kymberly and George Rapier lll Lead Unitrust charitable foundation (BKGR) and WellMed Medical Management has funded the Proyecto Bienestar — South San Antonio Study trial (PBSSA) for three school years beginning 2008 until 2011. The study is evaluating the program's impact through the implementation of the Bienestar/NEEMA coordinated school health program. The Social and Health Research Center (SHRC) in San Antonio, Texas is the coordinating center. The UTHSCSA Institutional Review Board (IRB) approved the study (IRB No. HSC20080443H).

This study is being conducted in 10 elementary and 4 middle schools in the South San Antonio Independent School District (SSAISD). The implementation of the Bienestar/NEEMA school health program is from kindergarten to eight grades and selected only the 6th grade cohort of students to evaluate its implementation. The goal of the intervention is to reduce or modulate risk for type 2 diabetes. The study focuses on reducing modifiable risk factors related to adiposity (excess body fat) and glycemic regulation (or control of blood sugar). The risk factors are BMI percentile > 95, indicating obesity, and levels of fasting capillary glucose screenings at > 100 mg/dL, indicating pre-diabetes and/or increased diabetes risk level.

Results of the baseline health screening data collected at the beginning of the school year 2008 - 2009 showed an 18.96% prevalence of positive screen for type-2 diabetes (At-Risk). Of the 44 children with positive screen for hyperglycemia 54.5% are obese (Insulin Resistance). At first follow-up (Spring of 2009), after only 4.5 months of Bienestar/NEEMA intervention these numbers were seen to decline by 9.12 % and 8.25 %, respectively for diabetes and obesity rates.

Although the results are preliminary, the partnership between SSAISD, SHRC, BKGR, and WellMed has shown a promising progression in decreasing diabetes and obesity rates in school children.

A special thank you to WellMed Medical Management for their generous donation to fund the PBSSA program.

WellMed Medical Management is a diversified healthcare company and insurance provider serving more than 80,000 patients and insured members, mostly Medicare-eligible seniors in Texas, Florida, Arkansas and New Mexico. WellMed is an industry leader in medical risk management, highly effective disease management and chronic care programs, healthcare delivery services, and more.

WellMed is South Texas' largest physician-owned practice management company, specializing in senior health care since 1990. With more than 30 medical clinics in Texas and Florida, the vision of the healthcare company and insurance provider is to change the face of healthcare delivery for seniors.

Information About Diabetes

Diabetes is a serious and dangerous disease in which the body does not produce insulin or properly use the insulin it does produce. Insulin is a hormone that allows glucose or sugar to enter the cells of the body where it is used for energy. Untreated, diabetes may cause blindness, kidney failure, strokes, amputations, and heart attacks. The American Diabetes Association states that there are approximately 18.2 million persons with diabetes in the United States. There are two major types of diabetes, Type 1 diabetes and Type 2 diabetes.

Type 1 Diabetes

In Type 1 diabetes, formerly known as insulin-dependent diabetes or juvenile diabetes, the body does not produce insulin. It is caused by the malfunctioning of the pancreas, an organ that produces insulin. Type 1 diabetics must take daily insulin injections to control their glucose levels. Type 1 diabetes usually occurs during childhood or in young adults and occurs in 5%-10% of all diabetics.

Type 2 Diabetes

In Type 2 diabetes, formerly know as adult-onset diabetes or non-insulin dependent diabetes, the body produces insulin but does not use it properly. Glucose or sugar does not enter the cells and builds up in the bloodstream. Type 2 diabetes is the most common form of diabetes. A family history of diabetes, aging, a diet high in fatty food, a lack of fiber (fruits, vegetables and whole grains), obesity or overweight, a lack of physical activity, and race/ethnicity are the most common risk factors for developing type 2 diabetes. Certain racial/ethnic groups such as Hispanics, African-Americans, Native-Americans, and Asians are at a much higher risk of developing type 2 diabetes.   

Warning Signs and Symptoms

Some of the signs and symptoms of diabetes can include:

  • being very thirsty
  • frequent urination
  • frequent hunger  
  • tired and weak
  • losing weight without trying
  • having sores and wounds that heal slowly
  • having dry, itchy skin
  • loss of feeling in your feet or tingling sensations in the feet
  • having blurry eyesight

A person with diabetes may have one or more of these signs or they may have no signs at all.   However, the more of these signs a person has, the quicker they should check with a physician .  

Complications

Complications resulting from diabetes can include:

  • Blindness - Diabetes is the leading cause of blindness in the U.S.
  • Heart disease/heart attacks - Heart disease is the leading cause of diabetes-related deaths.
  • Kidney failure - Diabetes is the leading cause of end stage kidney disease
  • Amputations - Amputations are disproportionately higher in Hispanics and African-Americans
  • Strokes - The risk of strokes is 2-4 times higher in people with diabetes.

Prevention

Type 2 diabetes has become an epidemic. Not only is it increasing in adults, but now more and more children are developing the disease. The Bienestar Health Program is a school-based diabetes prevention program designed to teach children how to prevent diabetes. Children learn how to prevent diabetes by:

  • Cutting back on fatty/greasy foods
  • Increasing fiber intake (eating more fruits, vegetables, and whole grains)
  • Increasing physical activity
  • Preventing obesity