Neighborhood Health Talkers: Helping Individuals and Families “Live Diabetes Well“ through Community Conversations

Objective: Self-management of chronic conditions like diabetes requires education about the condition tailored to culturally specified beliefs, world views, and lifestyles.  This paper discusses the development and implementation of a Cultural Health Broker (CHB) program in Buffalo, NY.  CHBs bridge the epistemological gaps between community members and their healthcare providers, facilitating the development of effective plans for self-management of health care needs.

Methods:  Pre- and post- knowledge and attitude surveys and daily “quizzes” were used to measure the one-week in-class Health Talker training program. Each of 13 Health Talkers conducted 5 community conversations. To measure the impact of these we conducted anonymous surveys with participants and the Health Talkers wrote summaries.  We used descriptive statistics for the pre- and post- Health Talker surveys and the conversation participant surveys. Qualitative analysis was used to identify common themes in community conversation summaries and open-ended survey responses.

Results: Health Talkers improved their knowledge and attitude about diabetes and their ability to help others self-manage. The Health Talker conversations reached over 600 people in 3 months. About 20% of conversation participants had diabetes while nearly 80% had a family member with diabetes. The majority (65-75%) indicated increased knowledge and confidence about self management after participation.

Conclusion: Training community members as Neighborhood Health Talkers is an effective strategy to increase knowledge and confidence about diabetes self-management among members of an urban, underserved, minority community. When you meet people where they are, it decreases the level of systemic barriers and minimizes access issues inherent to complex urban health care systems.