Establishing Diabetes Self-Management in a Community Health Center Serving Low-Income Latinos

Purpose The purpose of this study is to describe the implementation of the chroniccare model for Latinos with diabetes. Additional interventions to enhancedisease self-management were also implemented. Programmatic elements aredescribed, data are reviewed to characterize the extent to which patients wereengaged in various activities, and changes in glycosylated hemoglobin (HbA1c)are presented. Methods Culturally appropriate self-management activities were implemented over acourse of 3 years to offer a variety of options in which to engage patients.Bilingual (Spanish/English) multisession activities include formal diabeteseducation classes, an exercise class, and chronic disease self-managementclasses. Informal drop-in sessions include breakfast and snack clubs.Individual interactions include consultations with a nurse and nutritionist.Community health workers and community mentors also work with patients.Cross-sectional data from a disease registry, participation data, and clinicaldata on glycemic control are presented. Results Glycemic control for this population of Latinos with diabetes improvedfollowing implementation of the self-management program. Nearly half of alldiabetic patients participated in self-management activities, andparticipation was associated with improved glycemic control. Conclusions The self-management activities were successfully implemented to improvediabetes self-management for low-income Latino patients. Nearly one half ofthe patients reached a target goal of HbA1c