The Effectiveness of a Community Health Program in Improving Diabetes Knowledge in the Hispanic Population: Salud y Bienestar (Health and Wellness)

Abstract

We evaluated the effectiveness of the Salud y Bienestar program to deliver diabetes education in the Hispanic population in the United States. This program uses a community outreach model where community health promoters are trained and then they deliver education to other community members regarding diabetes disease, risk factors, and ways to prevent and control disease. This intervention applies a one-group pre- and post-test design to improve diabetes knowledge. The intervention carried out in the states of California, Texas, and Washington DC. A total of 1,413 participants were enrolled. Of these, 73% were females, 46% were 65 years or older, 59% were Mexican, 64% had at least elementary education, 56% had lived in the US for more than 20 years, and 38% participants were self-reported diabetic. Among diabetic participants, a significant improvement was observed on diabetes knowledge when comparing pre- and post-test scores (13.7 vs. 18.6, P < 0.001; Cohen's d = 1.2). Among non-diabetic participants, diabetes knowledge also increased significantly after one-single training session (12.9 vs. 18.2, P < 0.001; Cohen's d = 1.2). The Salud y Bienestar program conducted by community health workers was effective approach to improving diabetes knowledge in the Hispanic population.

Metabolic Control, Nutrition Knowledge, Attitude and Practice in Non-Insulin-dependent Diabetic Patients from Kohgiluyeh and Boyer-Ahmad Province, South-West of Iran

“…In many countries, the diabetic education programs are implemented to improve diabetic knowledge, attitude and practices to reduce diabetic complications and costs. However, increasing the knowledge by itself may not be necessarily effective in promoting diabetic practices and management outcomes as shown in some studies (5,15,16,(27)(28)(29).…”

Linking Community Resources in Diabetes Care: a Role for Technology?

“…We define CHW as a member of the patient’s community being utilized in any of the aforementioned capacities but not formally trained as a clinical or healthcare professional. Community health workers have been shown to augment patient knowledge [22], improve clinical outcomes [23, 24], reduce disparities [25], and decrease costs [26] in diabetes care. One study even showed increased Medicaid savings when CHWs specifically matched patient needs to local resources [4•].…”

Exploring the Needs and Preferences for a Diabetes Self-Management Program in Hispanics Living in the Central Valley of California

“…A randomized control trial of Hispanic-American diabetics living in Dallas supported the effectiveness of education from a promotora in addition to clinicians at reducing subjects HbA1C. Prezio et al (2013) Another quasi-experiment supporting the use of community health workers was conducted among patient populations of three community-based health organizations in Texas, California, and Washington, D.C (Cruz, Hernandez-Lane, Cohello, & Bautista, 2013). Researchers trained community health workers or promoters over three days and created a curriculum with a training manual and tools for community health workers to use with study subjects.…”

“…Researchers and clinicians have tried various strategies in recent decades to lessen this growing area of health concerns for our nation's fastest growing demographic. Both Toobert et al (2011) and Rosal et al (2011) (Cruz et al, 2013;Hurtado et al, 2014;Prezio et al, 2013). Some of the latest innovations in teaching diabetes self-management include the use of mobile health devices (Sanjay Arora et al, 2014;Heisler et al, 2014); potential success of these types of interventions should only increase as more and more Americans are using smart phones and have home access to internet.…”

“…Though the evidence is promising for the success of community lay health worker programs (Cruz et al, 2013;Hurtado et al, 2014;Prezio et al, 2013), support for this type of educator was low in this population. This may be due to survey design; however, it is not recommended for the organization to explore this education route at this time without further support in follow-up studies.…”