A Community-based participatory evaluation of a diabetes and health disparities initiative among Boston public housing residents

Background: Diabetes self-management and lifestyle change pose a particular challenge for residents of public housing—including those of the Roxbury neighborhood of Boston. Roxbury public housing residents are three times more likely to have type 2 diabetes than Boston area residents. Culturally appropriate approaches to addressing diabetes in Roxbury were needed.

 

Intervention: Whittier Street Health Center (WSHC) implemented the Diabetes Care Coordination Program (DCCP) in an effort to identify and serve diagnosed and undiagnosed African-American women with type 2 diabetes living in public housing. Its comprehensive care services included: outreach, screenings, and educational sessions that are delivered by Diabetes Health Ambassadors— culturally-competent women from the community who have been diagnosed and successfully controlling type 2 diabetes. The Ambassadors are the essential link between public housing residents and the WSHC. Community-based services are delivered during outreach activities, such as coffee hour gatherings, in places where residents live. This paper describes the DCCP as part of the overall participatory evaluation of Bristol-Myers Squibb Foundation’s Together on Diabetes initiative.

 

Results/Lessons Learned:

A total of 980 African-American women were screened for diabetes, and 312 patients were referred and retained in the DCCP. The mean change in HbA1c levels was from 7.74% to 7.49% among DCCP participants; and 82 program participants lost over 900 pounds.

 

Conclusion: The intervention suggests that the DCCP, with its use of Ambassadors, can aid in diabetes care service delivery and in assuring full participation of public housing residents in diabetes care.