Improving diabetes self-management behaviors and clinical measures in indigenous and minority adults at a community health center

Diabetes is fifth leading cause of death in Hawaii. However, distinct socioeconomic and ethnic disparities in prevalence of diabetes, self-management behaviors, and diabetes-related complications exist. In Hawai`i, diabetes disproportionately affects Native Hawaiians, Filipinos, residents with low educational attainment, and households with low income. To reduce these disparities, a collaborative partnership among the Hawaii State Department of Health, Kokua Kalihi Valley Community Health Center (KKV), and the University of Hawaii has adapted the evidence-based Stanford Diabetes Self-Management Program. The program aligns with the chronic care model and is designed to empower adults to improve self-management behaviors and reduce diabetes-related complications. We incorporated cultural components into the program to enhance acceptability in the culturally diverse community at KKV. We assessed the fidelity of program delivery and examined clinical measures, such as BMI, blood pressure, blood cholesterol, and A1c, and health behavior change among persons with diabetes in this ethnically-diverse population. We will provide information on how we adapted the program, share tools and evaluation results, and discuss challenges and successes.