149985 Value of a promotora-led diabetes education class for Latinos as part of the Chronic Care Model

Sunday, November 4, 2007

Eric J. Gertner, MD, MPH , Department of Medicine, Lehigh Valley Health Network, Allentown, PA
Hannah D. Paxton, RN, BSN , Community Health & Health Studies, Lehigh Valley Hospital, Allentown, PA
Lynn M. Deitrick, RN, PhD , Department of Community Health and Health Studies, Lehigh Valley Health Network, Allentown, PA
Lissett Lahoz, BS , Health, ESU, East Stroudsburg, PA
Nyann Biery, MS , Family Medicine, Lehigh Valley Hospital, Allentown, PA
Alicia Rivera, BA , Promotora, Lehigh Valley Hospital, Allentown, PA
Deborah Muro , Internal Medicine, Lehigh Valley Hospital, Allentown, PA
Cynthia Atamian, BA , Internal Medicine, Lehigh Valley Hospital, Allentown, PA
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.

Learning Objectives:
1. Identify and assess three potential methods to evaluate a promotora program. 2. Explore the role of a promotora in the Chronic Care Model. 3. Assess the impact of the promotora program on the targeted population.

Keywords: Community-Based Partnership, Lay Health Workers

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.