203934 Diabetes Self-Care Management in a Community Health Center: Improving Clinical Outcomes through Health Education

Monday, November 9, 2009: 5:15 PM

Ranjita Misra, PhD , College of Medicine, Ohio State University, Columbus, OH
Julie Ribardo, PhD , Health Education & Prevention, Brazos Valley Community Health Centers, Bryan, TX
Mary Shaw, PhD , Center for the Study of Health Disparities, Texas A&M University, College Station, IN
Introduction: Diabetes self-care management is a crucial element of good diabetes care and can improve glycemic control. However, self-care management interventions must meet the needs of underserved minority populations. The purpose of this 2 year health education intervention was to improve self-care management behaviors and outcomes of underserved ethnic minorities at a federally-qualified health center in Texas. Individual one-on-one and group self-management education sessions were provided with trained bilingual health educators. Subjects comprised of 417 individuals with diabetes. However, only 100 participants were tracked over 18-months for changes in clinical outcomes. Result and Discussion: The majority were females (69.5%), Hispanic/Latino (66%), and uninsured (95%). African Americans had higher levels of hypertension than other patients. The focus on goal setting led to 62.3% of patients achieving at least one goal (out of nine) and included nutrition, exercise, blood glucose management, and weight management. Of those goals that were sustainable, 70% of patients kept up their behavior change for 6 months post initial goal setting in a random sample of 100 patients. A1c lowered significantly in Whites (p =0.03), Hispanics ( p =.001 ) and African Americans ( p =.001) as well as in both males (p=.003) and females (p<.001). While intervention reduced weight in the subsample (approaching significance; p=.097), it was not significant by ethnicity or gender. Systolic blood pressure reduced among males (p=.083) and fasting blood glucose among African Americans (p=.097). Conclusion: Health education was effective in significantly reducing A1c levels and improving goal setting especially among minorities.

Learning Objectives:
1. Describe the health education strategy used for improving self-care management behaviors by ethnicity and gender. 2. List the differences in clinical parameters by ethnicity and gender 3. Discuss critical components of a culturally responsive management and education program for underserved and minority patients with low health literacy.

Keywords: Diabetes, Education

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a diabetes researcher with epidemiological and intervention studies in the US, Mexico and India
Any relevant financial relationships? No

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.