269110 Transforming diabetes care in an underserved Asian population: Best practices in translating evidence-based interventions into practice in a community health center

Tuesday, October 30, 2012 : 9:15 AM - 9:30 AM

Jessica Yen, MS , North East Medical Services, San Francisco, CA
Stephanie Chen, NP MPH , North East Medical Services, San Francisco, CA
Background: Studies of diabetes in Asian Americans is limited, but data suggest diabetes prevalence is two to four times greater among Asian Americans compared to non-Hispanic whites. In addition, most diabetes management interventions have not been tested in an underserved, immigrant, low-income Asian population. For Federally Qualified Health Centers (FQHCs), the problem is compounded by limited resources with which to address this growing problem. Methods: A literature review of evidence-based interventions and best practices revealed that panel management and health coaching are promising, cost-effective models for diabetes management. Using the Chronic Care Model and Model for Improvement, we implemented a hybrid panel management/health coaching program. The implementation workgroup included doctors, a nurse practitioner, an RN, IT staff a health educator, clinical pharmacist, and an administrator to ensure a culturally relevant intervention tailored to clinic culture and patient needs. Results: 3 MAs split 1 FTE health coaching/panel management position to support 6 provider's diabetic panels. At the end of 2011 there were 633 patients in the diabetes registry: annual HbA1c testing rates had increased 12.6% (p=.001), LDL testing rates increased 12.6% (p<.01), eye exam testing rates increased 75.4% (p<.0001). Preliminary results indicate an increase in glucose control (HbA1c<7). Conclusions: Implementation of a hybrid panel management/health coaching model shows promise for improving diabetic care in FQHCs serving a low-income, underserved, immigrant Asian population. Key personnel reflect upon lessons learned, best practice recommendations.

Learning Areas:
Administer health education strategies, interventions and programs
Chronic disease management and prevention
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs

Learning Objectives:
Describe components of a culturally-sensitive, linguistically appropriate Diabetes management program for underserved populations. Identify the clinical and operational infrastructure necessary to translate evidence-based interventions to a community health center setting.

Keywords: Community Health Centers, Diabetes

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I lead the Population Management Committee that oversees implementation of our diabetes management program. I am the “administrative champion” for the project and have led program planning, design, implementation, and evaluation in close collaboration with our "clinical champion."
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.