Taking Control of Your Health: How Poor Latino Immigrants Living in Urban DC do It!

Background: Catholic Charities Medical clinics prioritize preventive care as part of a comprehensive and patient-centered model of care. We partnered with the DC Department of Health and the DC Primary Care Association to offer the Chronic Disease Self-Management Program (CDSMP) to our patients. Chronic Disease Self-Management Program (CDSMP) was developed by a team of researchers at Stanford University. It’s a self-management education workshop for people with a variety of chronic health conditions. It aims to build participants’ confidence in managing their health and keep them active and engaged in their lives. The Spanish version is called “Tomando Control de su Salud”.

Purpose: Improve physical and psychosocial outcomes and quality of life for Latino immigrants living with hypertension and other chronic conditions through the Chronic Self-Management Program.

Methods: Our DC Medical clinic offered two six week workshops conducted by two staff members certified in the Stanford method’s CDSMP. At least 10 patients with chronic health conditions were invited to participate in each workshop.

Participants attended a 2 ½-hour interactive workshop once a week for six weeks to learn problem-solving, decision making, and other techniques for managing problems common to people with chronic diseases. At each class, participants set a realistic goal for the upcoming week and developed an action plan for meeting that goal. They reported on their progress at the following class, and solicited feedback from the group to help address any challenges. Key activities included interactive education, discussion, brain storming, and practice of action-planning, behavior modeling, problem-solving techniques and decision making. Symptom management included exercise, relaxation, communication, healthy eating, and medication management. At each session, a medical assistant took vital signs and collected blood to analyze low density lipoprotein (LDL) and HgA1c levels. CDSMP outcomes were recorded in our electronic health record. At the end of the sixth class, patients completed a satisfaction survey.

Outcomes: Patients participating in Tomando Control de su Salud will show a reduction in at least one of the following measures: blood pressure, weight, BMI, abdominal circumference, LDL or HgA1c. At the end of the workshop, patients will be able to name two specific behavior changes that have resulted from participating in the course and one behavior that they will maintain after the end of the program.

Conclusions: Evidenced-based, self-management education programs have been proven to significantly empower people with chronic disease(s). Tomando Control de su Salud participants gained an increased understanding of how to live healthier lives through better food choices and physical activities. We need to continue these workshops to help support patients’ positive behavior changes. We plan to invite successful patients to lead some of the discussions and continue to implement more workshops throughout the year using additional local funding sources. The Latino community in Washington DC experiences an overburden of obesity, diabetes and chronic disease, along with poverty. By educating and empowering this population with healthy lifestyle tools and resources, they will be able to access and choose healthier options to make healthy living sustainable for them and their families.