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APHA Scientific Session and Event Listing

Suzanne Kotkin-Jaszi, DrPH, Health Science Department, California State University, 2345 East San Ramon Avenue, MS M/H 30, Fresno, CA 93740-8031, 5592785387, skotkin@csufresno.edu

Diabetes in Mexican Americans is a serious health challenge because of the increased prevalence of diabetes in this group, the greater number of risk factors for diabetes, higher incidence of several diabetes complications, and the growing population of people of Mexican descent in the United States. This presentation will describe a community-based intervention focused on changing both individuals' risk behaviors and clinic process improvement at Corcoran District Hospital in Kings County California. This is an example of a community-university collaborative project centered in a rural, Latino, largely immigrant farm worker community.

The main goal of Conexiones y Cuidar (Connections and Caring, C & C) was to develop a comprehensive, culturally appropriate, community-participatory and evidence-based diabetes prevention and management program. The program combines features of successful clinic-based quality improvements designed to reduce racial/ethnic disparities in diabetes care and outcomes with a family-oriented, educational and social support approach to changing diabetes relevant attitudes and behavior.

The self-management training emphasizes family and social support to change social norms around diet, physical activities, and adherence to medical advice for diabetes management, goal setting for weight loss, diet and exercise logs, and learning how to overcome barriers to self-care such as the propensity not to follow the diabetic diet or do physical exercise. The clinic process improvement focuses on "best practices” using continuous quality improvement to identify and implement changes in clinic protocols to increase overall rates of adherence to national standards. Promotoras de salud (lay health advisors) were an essential component of this strategy.

Learning Objectives: At the conclusion of the session, the participant (learner) will be able to

• Describe the need for diabetes self-management programming in the rural, Latino community;
• Articulate the best practices for providing self-management education for this population;
• Identify changes in primary care process management that support self-management; and, 4)Recognize the cultural competencies needed by providers to support behavioral change in their patients.

Keywords: Diabetes, Self-Management

Presenting author's disclosure statement:

Any relevant financial relationships? No