Online Program

Improving self-management skills and hemoglobin A1C through a community health worker intervention

Monday, November 4, 2013 : 8:50 a.m. - 9:10 a.m.

Jessica Solares, MPH, MCHES, Health Education, AltaMed Health Services Corp., Los Angeles, CA
Maria Guadalupe Lara, MD, MPH, MHA, Health Education Department, AltaMed Health Services Corp., Los Angeles, CA
The devastating effect of diabetes on personal health and healthcare systems has been widely documented in various peer review journals. These effects especially manifest at community health care centers in Los Angeles County¬ówhere low income families and uninsured populations are predominately served. The Health Education Department embarked on an internal study to capture the positive effect of health education (as provided by an in-house Community Health Worker) on clinical and non-clinical outcomes. A cohort of about 30 diabetic patients, including newly diagnosed and poorly-controlled cases, was tracked over a six month period. Before and after the study, each patient completed an evidence-based self-efficacy evaluation to determine their perceived confidence level in managing their chronic condition. During the study period, each patient received a minimum of four counseling sessions with a Community Health Worker (CHW). Sessions were conducted in a clinic setting and were generally face-to-face, lasting 60 to 90 minutes. During these sessions, patients learned a variety of topics relevant to diabetes care. CHWs followed up with patients via phone to monitor progress on self-management goals as well as to discuss barriers to making change. Once internal study concluded, we noted that self-efficacy scores significantly improved post intervention assessment. Also, more than half of the patients who received health education lowered or maintained their hemoglobin A1C. Based on these results, we infer that CHWs play a crucial role in educating and motivating patients to change health behaviors which in turn lead to improved clinical outcomes.

Learning Areas:

Chronic disease management and prevention
Planning of health education strategies, interventions, and programs
Public health or related education

Learning Objectives:
Evaluate the effectiveness of the described diabetes self-management program. Describe how A1C can be positively impacted by Community Health Worker intervention. Identify other self-management tools or concepts that can be integrated into existing self-management programs for better clinical outcomes.

Keyword(s): Community Health Advisor, Diabetes

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: In my five years as the Mngr. of Health Education &Promotion, I have gained experience in implementing/managing multiple preventive evidenced-based programs that include lifestyle interventions such as healthy eating , physical activity and stress management. I possess expert knowledge on chronic disease topics including diabetes. My expertise/passion is health education, specifically, how to deliver health information to lay persons in a digestible format.
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.