Project Dulce's diabetes peer educator program assessment on behavioral outcomes: January 2008 – November 2008

Purpose: To assess the impact of Project Dulce's peer-led diabetes self management classes on health behaviors.

Background: Project Dulce (PD) uses multidisciplinary nurse-led teams, dieticians and trained peer educators to deliver culturally appropriate diabetes care. Project Dulce's peer educators are patients with diabetes or their relatives from the same cultural and ethnic group as the class participants. Project Dulce developed the Diabetes Among Friends curriculum, that focuses on empowering patients to improve diabetes management in a series of 8 classes.

Methods Project Dulce's diabetes self-management classes were taught at community sites and clinics throughout San Diego County from January to November 2008. The Summary of Self-Care Activities Survey(Toobert et.al.,2000) was administered to 133 participants prior to the first PD class and after the last class. Self-reported adherence to diet, physical activity, glucose testing and medication were evaluated. Analysis included descriptive statistics, pre and post paired sample t-tests and analyses of variance.

Results: Participants were primarily Hispanic/Latinos (98%), uninsured (66%), Spanish-speaking (98%) and female (78%). Significant, self-reported improvements in adherence to diet (t=-7.2, p<0.001, n=59), physical activity (t=-3.21, p=0.0036, n=26), and glucose testing regimens (t=-3.73, p<0.001, n=22) were identified. No significant difference for medication adherence was noted.

Conclusions: Results suggest that the Project Dulce diabetes management classes positively impact attendees' self-reported adherence to nutrition, physical activity and glucose testing regimens. The program shows great potential to positively impact uninsured and ethnically diverse populations. Adaptation and testing of the PD model is underway throughout communities in the US and in Mexico.