Community-based Diabetes Education for Latinos: The Diabetes Empowerment Education Program.

摘要

PURPOSE: The purpose of this study was to conduct a diabetes education program delivered by community health workers (CHWs) in community settings and to evaluate its effectiveness in improving glycemic control and self-management skills in Hispanics/Latinos with type 2 diabetes. METHODS: Trained CHWs recruited Hispanic/Latino community residents with self-reported type 2 diabetes, implemented intervention in nonclinical locations, and collected data on diabetes knowledge, self-care behaviors, self-efficacy, depression, A1C, weight, and blood pressure. Classes applied participatory techniques and were delivered in 2-hour group sessions over 10 weeks. Two focus groups collected qualitative postintervention data. RESULTS: Seventy participants enrolled, and 47 completed pretest and posttest data. Improvements were significant for A1C (P = .001) and systolic blood pressure (P = .006). Other positive outcomes were diabetes knowledge, physical activity, spacing carbohydrates, following a healthy eating plan, and eating fruits and vegetables. Improved behaviors also included foot care, glucose self-monitoring, and medication adherence. Depressive symptoms showed a positive trend in intent-to-treat analysis (P = .07), but self-efficacy did not change significantly (P = .142). Qualitative information reported an increase in participants' perceived competence in self-care and a positive influence of CHWs in participants' compliance with the program. CONCLUSIONS: A diabetes self-management education program for Hispanics/Latinos led by CHWs can be implemented in community settings and may effectively improve behavioral skills and glycemic control.