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Diabetes Educ. 2012 Sep-Oct;38(5):723-32. Epub 2012 Sep 10.

En Balance: the effects of Spanish diabetes education on physical activity changes and diabetes control.

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  • 1Loma Linda University, School of Public Health, Nutrition, 24951 N Circle Dr., Loma Linda, CA 92354, USA.



This study was designed to assess the feasibility of culturally and language-sensitive diabetes education as a way to increase physical activity and to improve health/diabetes management in a group of Spanish-speaking Hispanics in the Inland Empire region of Southern California.


En Balance is a culturally sensitive diabetes education program designed for Spanish-speaking Hispanic adults. The 3-month educational intervention assessed 16 males and 23 females living in Riverside and San Bernardino counties of Southern California. Baseline and 3-month evaluations of physical activity were assessed using the validated Arizona Activity Frequency Questionnaire.


After 3 months on the En Balance program, there was a significant increase in moderate intensity physical activity energy expenditure (M = 368 ± 894 kcal/day, P < 0.01) and high intensity physical activity energy expenditure (M = 405 ± 2569 kcal/day, P = 0.05) compared to baseline and significant reductions in A1C (-0.90%, P = 0.01), total cholesterol (-13.44 mg/dl, P = 0.01), LDL cholesterol (-10.28 mg/dl, P = 0.03), and waist circumference (-1.52 cm, P = 0.04).


En Balance program resulted in significant mean increases in both moderate and high intensity physical activity energy expenditure among this group of Hispanic diabetic participants, indicating that despite a general pattern of low physical activity in this group, an intervention that stresses both nutrition and exercise in culturally sensitive ways can positively impact participant's physical activity levels as well as impact nutritional changes.

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