Increasing Hispanic Enrollment and Adherence in Diabetes Programs

Objective: (1) To understand why enrollment and adherence rates in Diabetes management and prevention programs are so consistently low among Hispanics. (2) to undercover unique motivators and sustainable strategies for increasing enrollment and adherence rates.

Methods: In close collaboration with Blue Cross Blue Shield of Texas and H-E-B, a large supermarket company in Texas, we conducted a series of qualitative and quantitative studies. Two rounds of studies have been completed; two more are in process for completion by January 2010.

Results: The initial rounds of assessments and focus groups revealed: (a) very poor and culturally insensitive communications and enrollment materials, (b) a lack of culturally- and linguistically proficient recruitment staff, (c) poor coordination among service sections, (d) a small group of Hispanics that were enrolled and adhering to the program, and (e) specific attitudes and practices that can be rolled out to larger audiences.

Conclusion: Poor engagement with Hispanics around diabetes is reaching epidemic proportions. Current attempts to engage Hispanics by health plans and employers are expensive and ineffective. Low-cost, culturally-optimized strategies are possible and are being evaluated for their impact on enrollment, adherence and health outcomes.