Innovative methods to capture the work of promotores as patient educators and advocates in the care of diabetes management

Using the community health worker (Promotor) model, Latino Health Access' 12-week diabetes self-management program has shown significant reduction in participants' A1C levels; however, this reduction diminishes or disappears over time. Promotores identified a need to create a program that would assist participants become more active in self-managing their diabetes beyond the 12-week class series. The diabetes extended care program was created and participants showed statistically significant reductions in A1C, lipids and blood pressure values. This presentation will focus on how Promotores were involved in the design and implementation of the extended care program as well as assisting in the development of process evaluation tools, including a web-based Promotor-friendly registry. More importantly, it will highlight the amount of work Promotores spend in achieving outcomes. Tools captured the intensity of Promotores' efforts, in hours of service, type of service (i.e., in-person and telephone contact) and area of focus, ranging from self-management to provider communication recommendations. Results showed that each participant, of the 255 enrolled, received on average 10 hours of services from Promotores, these included in-person visits, telephone intervention and reminder calls. These data show that in-person visits were the most time consuming, yet an indispensable component of the program. Discussion will also focus on the benefits and challenges that Promotores faced in documenting their efforts, using the web-based registry, and lessons learned to include Promotores' feedback on the design and implementation of the program.