247182 Development and Implementation of a Culturally-Sensitive and User-Interactive Diabetes Education Program for Mexican immigrants in Philadelphia, PA

Monday, October 31, 2011

Gina Siddiqui , School of Medicine, University of Pennsylvania, Philadelphia, PA
Annemarie D'Amato , School of Nursing, University of Pennsylvania, Philadelphia, PA
Steve Larson, MD , Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA
Annette Silva, LPN , Nursing, Puentes de Salud, Philadelphia, PA
Matthew James O'Brien, MD , School of Medicine, Temple University, Philadelphia, PA
Background: Type II diabetes is a nationwide epidemic that disproportionately affects U.S. Latinos. A constellation of health disadvantages, such as lack of insurance, language barriers, fragmented social supports, difficulty navigating available resources, and poor nutrition have put recent Mexican immigrants in Philadelphia at high risk for diabetes and its related complications.

Methods: Following stakeholder interviews and a comprehensive literature review of community-based interventions for diabetic Latinos, an eight-session, 24-hour curriculum was developed. Innovative elements of the program included a cooking class with dishes developed and presented by a Mexican chef, involvement of diabetic participants' support structures, and participant-generated visual teaching tools. Evaluation of the program included clinical data and qualitative data from focused interviews.

Results: A pilot program was delivered in Spanish by a clinic nurse with a three-year ongoing relationship with the community. The education component was fully integrated with clinical care at the local community health center from which participants were recruited. One program graduate no longer needed oral medications to manage his blood sugar after losing twenty pounds. Another participant expressed that, beyond insights about behavioral changes in diet and exercise, the program built a network among her peers to share common struggles, inspiring her to “seguir luchando [keep fighting].” The program's next iteration will involve trained promotoras (local community health workers), more user-generated teaching content, and robust outcomes metrics.

Conclusions: A culturally-sensitive education program developed with community input has the potential to inspire lifestyle changes and prevent diabetes-related complications, particularly for vulnerable populations in resource-strained settings.

Learning Areas:
Assessment of individual and community needs for health education
Chronic disease management and prevention
Diversity and culture
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Public health or related public policy

Learning Objectives:
1. Describe the process of initiating a culturally relevant diabetes program in an urban Latino immigrant community 2. Discuss challenges and successes of an academic-community partnership between the University of Pennsylvania and Puentes de Salud, and how it affected the planned health intervention 3. Assess the impact of integrating diabetic patients’ social supports into education efforts 4. List outcomes of diabetes knowledge outreach, both quantitative (HbA1c) and qualitative (Diabetes Knowledge Questionnaire, Diabetes Self-Efficacy Score)

Keywords: Community-Based Health Promotion, Latino Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I developed this diabetes education program, conducted the prior comprehensive literature review, and supervised its implementation and team recruitment. I work at the affiliated local community clinic, and was responsible for patient recruitment and coordination with medical services.
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.