Renu Joshi1, Nirmal Joshi, Amy Helmuth. 1. Department of Endocrinology, Fredrickson Health Center, Pinnacle Health System, Mechanicsburg, Pennsylvania 17050, USA. rjoshi@pinnaclehealth.org
Abstract
OBJECTIVE: To describe a project aimed at improving diabetes care in the ambulatory setting among 2 high-risk racial minorities (African American and Hispanic patients) by using culture-specific education provided by trained diabetes educators from the same racial groups as the targeted patients. METHODS: Two nurse educators, 1 Hispanic and 1 African American, completed a standardized chronic disease management program, as did 2 patients with diabetes from each of the aforementioned ethnic groups in preparation for training other patients. The study patients participated in group classes or one-on-one sessions to learn about appropriate management of their diabetes, related complications, and improved lifestyle habits. Close follow-up by telephone and regular appointments ensured that appropriate glucose monitoring and laboratory tests were performed. Outcome measures before and after the intervention were recorded, with final project follow-up at 24 months. A control group was identified during the same period, which received standard care (follow-up with a physician every 3 to 6 months). RESULTS: An improvement in control of diabetes occurred, as determined by a significant decline in hemoglobin A1c levels in both minority study groups. Emergency department visits also decreased significantly. Lipid profiles and microalbumin showed improvement as well. More than 90% of patients kept appointments and had all laboratory studies performed. CONCLUSION: The project intervention had a notable effect, physically and psychologically, on the 2 ethnic sample populations studied. These results have major implications, both clinically and financially, for public health policy planning for diabetes care in minority populations.
OBJECTIVE: To describe a project aimed at improving diabetes care in the ambulatory setting among 2 high-risk racial minorities (African American and Hispanic patients) by using culture-specific education provided by trained diabetes educators from the same racial groups as the targeted patients. METHODS: Two nurse educators, 1 Hispanic and 1 African American, completed a standardized chronic disease management program, as did 2 patients with diabetes from each of the aforementioned ethnic groups in preparation for training other patients. The study patients participated in group classes or one-on-one sessions to learn about appropriate management of their diabetes, related complications, and improved lifestyle habits. Close follow-up by telephone and regular appointments ensured that appropriate glucose monitoring and laboratory tests were performed. Outcome measures before and after the intervention were recorded, with final project follow-up at 24 months. A control group was identified during the same period, which received standard care (follow-up with a physician every 3 to 6 months). RESULTS: An improvement in control of diabetes occurred, as determined by a significant decline in hemoglobin A1c levels in both minority study groups. Emergency department visits also decreased significantly. Lipid profiles and microalbumin showed improvement as well. More than 90% of patients kept appointments and had all laboratory studies performed. CONCLUSION: The project intervention had a notable effect, physically and psychologically, on the 2 ethnic sample populations studied. These results have major implications, both clinically and financially, for public health policy planning for diabetes care in minority populations.