Communicating culturally and linguistically appropriate diabetes information: Dulce New Jersey diabetes disease management program

The Dulce New Jersey project was designed to help New Jersey hospitals close the gap in diabetes care for minorities by, among other strategies, providing linguistically and culturally appropriate diabetes education and improving the communication between clinical care providers and the patient. This two-year demonstration project is aimed at improving the health outcomes of New Jersey minorities with diabetes, particularly Hispanics/Latinos and African Americans, who have traditionally exhibited poor diabetes management and outcomes and are at high risk for disease complications. The project modified and uses a “Project Dulce” model originally developed in California; it has been piloted in three New Jersey hospitals with primary care clinics and ADA-recognized diabetes education programs. The model employs complementary strategies of nurse-managed clinical care and community-based health education/promotion. The health education is provided by trained peer educators who lead culturally and linguistically appropriate eight-week education courses for individuals with diabetes from the same community, using a curriculum that promotes healthy lifestyles, provides culturally relevant health and nutrition tips and addresses cultural beliefs in ineffective remedies. The materials provided use universal pictorial images with text available in the patient's primary language. Peer educators also follow up with patients, to ensure their compliance with appointments and self-care regimens, and provide support with understanding and communicating with providers. Long-term plans are underway to expand to additional sites, promote further replication of the model throughout New Jersey and establish a regular training program relying on previously trained nurses and educators to share their knowledge.