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Insights on promotores as essential members of an interdisciplinary healthcare team: Creating a model of excellence in diabetes self-management for Hispanics

Julia D Portale, MPH, MBA1, Lourdes Rangel2, Lucy Garcia, RN, BSN3, Angela J. Camilleri, MPH, MA1, Eileen Crowley1, Kenneth S. Babamoto, PharmD, MPH1, Grizelda Price2, Vicki J Karlan, MPH4, Carlos N. Casas-Zaragosa, MD3, and Miguel Trevino2. (1) Community Health, Pfizer Health Solutions, 235 East 42nd Street (150/37/5), New York, NY 10017, 212-573-5601, julia.portale@pfizer.com, (2) Gateway Community Health Center, 2309 Saunders, Laredo, TX 78044, (3) Gateway Community Health Centers, Inc., 2309 Saunders, Laredo, TX 78044, (4) Outcomes and Analytics, Pfizer Health Solutions, 2400 Broadway, Suite 500, Santa Monica, CA 90404

Effective strategies to decrease health disparities for conditions such as diabetes among the Hispanic population includes Community Health Workers (CHWs) or Promotores. Their role can be greatly maximized with internal support from clinic providers and staff when they embrace CHWs as part of the healthcare team. A successful, integrated CHW-based diabetes program has been demonstrated at Gateway Community Health Center in Laredo, TX. Approximately 40% of the clinicís population receives care for diabetes, far exceeding national norms indicating 13.6% of Hispanic adults have diabetes, almost twice that for non-Hispanic whites. Recognizing the need for additional help to address this escalating health disparity, Gateway has implemented Amigos en Salud, a program developed in partnership with Pfizer Health Solutions, which trains CHWs to educate Hispanics with diabetes to develop and maintain self-management skills and behavior change. CHWs support patients by providing a culturally relevant education curriculum, connecting patients and their families to the healthcare system and available community resources. The skills and responsibilities of CHWs have been successfully woven into clinic operations, complementing the efforts of clinical and non-clinical staff. CHWs work synergistically with the healthcare team, reinforcing and simplifying providerís treatment plan in areas such as nutritional counseling, ensuring appointment keeping and participation in clinic programs. This CHW model enhances patient, family members and provider continuity and coordination of care, while increasing the delivery of quality care in the clinic. CHW insights into achieving clinic support, strategies for successful implementation and suggestions for overcoming obstacles will be discussed.

Learning Objectives:

Keywords: Hispanic, Community Health Promoters

Presenting author's disclosure statement:
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Employment

From Rural to Urban: Community Health Workers Promoting Healthy Communities

The 132nd Annual Meeting (November 6-10, 2004) of APHA