Community-Based Diabetes Education for Latinos: the Diabetes Empowerment Education Program

Purpose: The purpose of this study was to conduct a diabetes education program delivered by community health workers in community settings; and evaluate its effectiveness in improving glycemic control and self-management skills in Hispanic/Latinos with type 2 diabetes. Methods: Trained community health workers recruited Hispanic/Latino community residents with self-reported type 2 diabetes, implemented intervention in non-clinical 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 post-intervention data. Results: Seventy participants enrolled, and 47 completed pre- 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 program. Conclusions: A diabetes self-management education program for Hispanic/Latinos led by CHWs can be implemented in community settings, and may effectively improve behavioral skills and glycemic control.