Gertner, Eric J, MD, MPH

Paxton, Hannah D, RN, MPH

English

Lehigh Valley Health Network: LVHN Scholarly Works

Lehigh Valley Health NetworkLVHN Scholarly WorksDepartment of Family MedicineThe Value of a Promotora-led Diabetes EducationProgramEric J. Gertner MD, MPHLehigh Valley Health Network, Eric.Gertner@lvhn.orgHannah D. Paxton RN, MPHLehigh Valley Health Network, Hannah_D.Paxton@lvhn.orgFollow this and additional works at: http://scholarlyworks.lvhn.org/family-medicinePart of the Medical Specialties CommonsThis Presentation is brought to you for free and open access by LVHN Scholarly Works. It has been accepted for inclusion in LVHN Scholarly Works byan authorized administrator. For more information, please contact LibraryServices@lvhn.org.Published In/Presented AtGertner, E. Paxton, H. (2007, October 1). The Value of a Promotora-led Diabetes Education Program. Presented at: Lehigh Valley HealthNetwork, Allentown, PA.The Value of a Promotora-led Diabetes Education ProgramEric Gertner, MD, MPH, FACPLehigh Valley Physician PracticeAssociate Professor of Clinical MedicinePenn State College of MedicineHannah Paxton, RN, BSNPopulation Health NurseLehigh Valley HospitalContext Self management for chronic disease is an essential component of the Chronic Care model.  While most diabetes programs are offered in English, the Promotora program provides diabetes education in Spanish to patients whose primary language is Spanish. Study Goal Pilot study to determine if diabetes education in the patients’ native language (Spanish) is feasible and might improve self management of diabetes through greater understanding of disease and self-management processes. Design Volunteer cohort of diabetics, referred by primary care physicians. Setting Three inner-city primary care locations with large Spanish speaking populations. Population All Spanish speaking diabetic patients were eligible. Intervention A six week diabetes education class taught in Spanish by a trained lay health worker.  The curriculum focused on increasing patients’ knowledge about self-management, including diet, ability to use and understand a glucometer, and prevention of long-term complications. PromotoraRecruitinglistSix sessionsTwo hour sessionsFollow-up sessionsScreeninglist of patientsSession 1Introduction3rd MonthFollow-up sessionGrouping of patients9 to 12 participantsSession 2Sugar LevelsSession 3Exercise and MedicineSession 4DietSession 5Complications and ProblemsSession 6Conclusion/Summary6th MonthFollow-up session9th MonthFollow-up session12th MonthFollow-up sessionFormsFormsOutcome Measures Knowledge was assessed through a pre/post-intervention questionnaire. The Patient Enablement Index (PEI) measured patient activation at the completion of the intervention and at 3 and 6 months. Focus groups were held post-intervention to explore patients’ experiences in the group, with particular attention to the experience of learning in their native language, the role of group support in learning and activation, and how attitudes about illness may have shifted as a result of the intervention. Follow-up Questions for Participants How have you been able to control your diabetes in the past three months? Does your family support you with your diet and diabetes management?  Have you visited your doctor since the last class and/or your last follow-up?  Would you be willing to attend a refresher class to help you maintain your diabetes? Are you using your Glucometer?Results Respondents valued the classes and appreciated learning about diabetes in Spanish with sensitivity to their cultural identity.  Key outcomes included: increased knowledge about diet; ability to check blood sugar using a glucometer; and increased knowledge about diabetes self management.  Clinical indicators did not change during the study period. Promat oraC lass 1  t hrough 3( 6  mont hs)-2.0-1.00.01.02.03.04.05.06.07.08.01 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23P a t i e ntGoal HbA1c <7.0 (0.0 represent goal)HbA1c <7.0 Prior HbA1c <7.0 PostConclusions This pilot suggests that diabetes education in the patients’ native language is feasible.  Further research to describe outcomes should include clinical data markers, and longer follow-up periods for knowledge, activation and behavior change measures. Questions?

The Value of a Promotora-led Diabetes Education Program

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The Value of a Promotora-led Diabetes Education Program

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