Value of a promotora-led diabetes education class for Latinos as part of the Chronic Care Model

Purpose: Self-management for chronic diseases is an essential component of the Chronic Care Model. Providing culturally sensitive education with a promotora for self-management should provide measurable health benefits in this model. We analyzed clinical indicators, Patient Enablement (PEI) scores, and focus group data to determine the benefit of our program.

Methods: A 12-hour diabetes class program was taught by a promotora in Spanish to patients with limited English proficiency. Patients were referred by their primary care provider (PCP). Patients completed the PEI at 3, 6, and 9 months post class. Hemoglobin A1C, weight, blood pressure, and cholesterol were monitored by the patients' PCP. A cross-section of patients was recruited into 3 Spanish language focus groups to assess the value of the classes as an effective educational strategy for Latino patients.

Results: Respondents valued the classes and appreciated learning about diabetes in Spanish with sensitivity to their cultural identity. Key outcomes included increased knowledge about diet, ability to check blood sugar using a glucometer, and increased knowledge about diabetes self management. Clinical indicators did not change during the study period.

Discussion: Patients benefited from the classes and were able to interact, share information, and form social connections, which are culturally important to Latinos. Patients were able to identify with the promotora, who was cited as being respectful, trustworthy, friendly, concerned, and supportive. An increase in PEI scores supports the program's value to the patients. Measures of enablement and satisfaction may improve before clinical indicators; these will need further evaluation.