A health center team care approach to Chinese American diabetes disparities

Diabetes has emerged as a new epidemic across the US. Diabetes rates are growing faster among Asian Americans and Native Hawaiians/Pacific Islanders (AANHPIs) than in any other racial/ethnic groups. Diabetes rates for AANHPIs are higher in the US than in native countries. Approximately 10% of AANHPIs and 15% of Chinese have physician diagnosed diabetes, ~ 1.7 and 2.5 times higher than in the general U.S. population (5.9%). Diabetes rates for Chinese are 5 to 7 times higher in the U.S. than in native countries. This community-academic participatory study examines a culturally and linguistically proficient teamlet model of diabetes care among Chinese Americans with type 2 diabetes at a Federally Qualified Health Center, Asian Health Services (AHS), in Oakland, CA. The AHS teamlet intervention model incorporates health education through a health coach and dietician, as well as phone follow-up. The pilot intervention study compares HbA1c and other clinical, behavioral, and utilization measures from medical record abstractions and patient interviews at baseline, 3 and 6 months for the teamlet intervention (n=48) and usual care (n=48) groups. At baseline 81.9% of participants were overweight (per Asian BMI standards), 48.9% had systolic blood pressure ≥130mmHg, and 84.6% rated their health as poor or fair. Mean HbA1c was 7.6. Comparison of baseline, 3 and 6 month data will also be presented. Ultimately, the vision for this pilot intervention study is to design a larger effectiveness study of a culturally proficient multi-component diabetes team care intervention targeted to Chinese communities and implemented across community health centers.