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The Diabetes Educator, Vol. 33, No. Supplement 6, 151S-158S (2007)
DOI: 10.1177/0145721707304076
© 2007 American Association of Diabetes Educators; Published by SAGE Publications

FEATURES

Integration of a Promotora-Led Self-Management Program Into a System of Care

Corinne E. Joshu, MA, Lourdes Rangel, Otila Garcia, Carol A. Brownson, MSPH and Mary L. O'Toole, PhD

From the Department of Community Health, Prevention Research Center, Saint Louis University School of Public Health, St Louis, Missouri (Ms Joshu); Gateway Community Health Center, Laredo, Texas (Ms Rangel and Ms Garcia); and the National Program Office of the Robert Wood Johnson Foundation Diabetes Initiative, Division of Health Behavior Research, Departments of Internal Medicine and Pediatrics, Washington University School of Medicine, St Louis, Missouri (Ms Brownson, Dr O'Toole).

Correspondence to Corinne E. Joshu, MA, Department of Community Health, Prevention Research Center, Saint Louis University School of Public Health, 3545 Lafayette Avenue, St Louis, MO 63104 (joshuce{at}slu.edu).

Purpose

The purpose of this article is to describe the integration of a promotora-led self-management component into a system of care and assess the influence of this program on indicators of metabolic control over time.

Methods

Gateway Community Health Center is a federally qualified health center in Laredo, Texas, that serves a predominantly Hispanic population. Gateway integrated self-management support into care for people with diabetes by incorporating promotora-led self-management services into the clinic structure, operations, and patient visits. The self-management program included education, goal setting, depression screening with symptom follow-up, and support groups after course end. Indicators of metabolic control, HbA1c, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglycerides were compared at baseline and at 12 months.

Results

The integration of promotora-led self-management services into the system of care allowed for continual improvements of self-management services in response to patient needs. Patients enrolled in the self-management course showed improved indicators of metabolic control that were sustained over time, and they reported a high level of goal achievement.

Conclusions

The integration of the promotora-led self-management program into diabetes care at Gateway generated a system of referral, follow-up, feedback, and documentation that produced consistently high-quality clinical care.


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