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Community Support Helps Rural Hispanic Patients With Diabetes

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Publication Date: June 2008

Publisher(s): Robert Wood Johnson Foundation

Topic: Health (Health services for the chronically ill)


Open Door Health Center in Homestead, Fla., is a free clinic that provides primary health care as well as diagnostic and education services for the uninsured poor in the Homestead/Florida City area. Almost half of the population of the rural community is Hispanic, primarily from Mexico.

The Prescription for Health Diabetes Project, a Building Community Supports for Diabetes Care program, collaborates with academia, the faith community, a local foundation, a private hospital, volunteers and community-based organizations. To positively affect diabetes self-management in the target population, the project implemented the following tactics:

1. Recruited multicultural community health workers from the patient population to provide peer support and culturally and linguistically appropriate diabetes education to other clinic patients
2. Initiated group support appointments to encourage peer support and help patients understand self-management tools better
3. Linked participants with community resources (e.g., local social service agencies, community-based organizations, churches, after-school programs and media) to help address cultural myths and misperceptions related to diabetes
4. Began the Popular Education Method, a highly participatory learning process that builds on patients' existing knowledge; views the individual as the one who is capable of identifying and solving their own problems; and focuses on identifying participants' needs and interests as they relate to diabetes, including brainstorming sessions where participants can suggest ideas for personal application

Key Lessons:

* Improvement in diabetes self-management in a multiethnic community is possible through innovative collaboration and cultural competence.
* A successful system of care for diabetes that includes self-management can be created through partnerships and group support visits.
* Popular Education and other participatory methods are important when working with populations with varied literacy levels, cultural/ethnic backgrounds and languages in a primary care outpatient setting.


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