5 Steps to Self-Care – Peer Education Training for Patients with Diabetes in Mexico

In 2003, Project HOPE developed a 24-hour patient education course called “5 Steps to Self-Care.” Designed to improve outcomes in Mexico, where diabetes is the leading cause of death, “5 Steps” has been adapted by HOPE initiatives in New Mexico and S. Africa. “5 Steps” consists of 14 fully scripted sessions with accompanying interactive, non-reading based materials adapted to limited literacy needs. “5 Steps” facilitates group learning, building the necessary knowledge, skills and proactive attitude required to engage in daily diabetes self-care, while addressing prevailing cultural misconceptions and the need for social support. It encourages participants to share key messages from each session with others to grow reach. “5 Steps” has demonstrated effectiveness by improving clinical control, as measured by HbA1C, and decreasing depression, as measured by the WHO-5 survey, across age groups and learning levels. The “Lend a Hand in Self-Care” course was developed to train health professionals to replicate “5 Steps”, and has been successfully adopted by teams of multidisciplinary, primary health workers in two regional health districts outside Mexico City serving over 1 million people. “5 Steps” also spurred a peer education initiative, whereby patient graduates offer community-based screenings and education in neighborhood settings, in collaboration with HOPE-trained government health workers. To-date, some 3,000 patient graduates have shared how to prevent and live better with diabetes with over 100,000 family, friends and neighbors. Partnering with Project HOPE, the National University (UNAM) has used the “5 Steps” curriculum to launch a “Peer Educator” certification program.