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APHA Scientific Session and Event Listing

Recorded presentation

Dawn Heffernan, RN, MS, Holyoke Health Center, Inc, 230 Maple Street, P.O. Box 6260, Holyoke, MA 01041, 413- 420-2144, dawn.heffernan@hhcinc.org, Jeanette Rodriguez, Diabtes Program, Holyoke Health Center, Po Box 6260, Holyoke, MA 01041-6260, and Jon Liebman, MSN, MSPH, Adult Nurse Practitioner, Holyoke Health Center, PO Box 6260, Holyoke, MA 01041-6260.

Abstract

Community Health Workers in Chronic Disease Management: The Role of Promotores in Supporting Diabetes Self-Management with Latino Patients.

Community Health Workers (CHWs) have been used in many communities to provide health education and public health services. We report on an innovative program using promotores to improve clinical care and self-management skills of diabetic patients in Holyoke, Massachusetts. Front-line staff will speak to the development, operation and challenges of the CHW program.

Holyoke Health Center has over 1200 diabetic patients and has an integrated clinical and self-management program to improve outcomes. Since 2003 we have recruited and trained patients to become CHWs. These bilingual/bicultural men and women have demonstrated their ability to self-manage their own illness, and are employed to work with other patients in their homes and at the clinic. With supervision by a nurse, they assist in teaching short self-management classes, further strengthening their own training. They visit patients in their homes, and may accompany them to clinic visits. Their primary focus is to support patients' self-management skills, problem solve, improve medication adherence, and to assure continued participation in clinical care. Often, they work with our least successful patients. Supervision is close and ongoing to provide the support they need, and to help define the boundaries of their services. Clinical outcomes have been excellent. In the clinic as a whole, average A1c has dropped from 8.3 to 7.5 since the initiation of the promotor program.

Learning Objectives: