Implementation of an Evidence-Based Diabetic Screening Tool in Rural Belizean Communities

Significance/Background: Type II Diabetes Mellitus (TIIDM) is a growing epidemic in Belize. The prevalence is increasing yearly, responsible for considerable health complications and deaths. Rates are much higher in Belize than in any other developing Central American country, and many rural citizens are undiagnosed and untreated. Access to healthcare is complex, and travel is often required in rural areas. Primary care visits in Belize are significantly less than in surrounding North and Central American countries. As a result, chronic illnesses such as TIIDM often go undiagnosed among children, adolescents, and adults- leaving TIIDM a leading cause of death in Belize.

Purpose: to implement a diabetic screening tool in rural Belizean communities with the aims of (a) increasing TIIDM risk screening and (b) increasing blood glucose (BG) testing via mobile community clinics.

Implementation: Using the Johns Hopkins Nursing Evidence-Based Practice Model, a literature review and critical appraisal were performed to evaluate best practices for rural, community-based TIIDM screening. A validated risk factor screening form was selected and implemented in rural Belize communities.

Outcomes: Use of a community-based TIIDM screening tool to identify high-risk individuals increased the number of BG checks performed in a clinic setting in rural Belize.

Linking evidence to action: Community-based risk screening was an effective, low-cost method to improve BG testing and provide education about TIIDM risk factors. This may benefit other rural communities with high disease burden and limited access to care.