Promoting and Marketing DSME in Areas of Great Health Disparities

Background: African Americans are disproportionately affected by diabetes – they are 1.7 times more likely to develop diabetes compared to non-Hispanic whites.  In Cook County, Illinois the prevalence of diabetes in African American seniors is 42% compared to 23% in Caucasian seniors; and 14% higher than in African American seniors throughout the country. The rate of lower leg amputations in certain zip codes are the highest in the nation. The Centers for Medicare & Medicaid Services (CMS) working with Quality Innovation Networks – Quality Improvement Organizations (QIN-QIO’s) goal is to reduce these disparities through promotion of diabetes self-management education (DSME). DSME empowers people with the skills they need to effectively manage diabetes in an effort to limit the associated complications by promoting positive self-care behaviors such as healthy eating, being active, problem solving, healthy coping and self-monitoring.

Program background: The Illinois Telligen Diabetes Task Team utilizes the evidence-based DEEP curriculum (Diabetes Empowerment Education Program) from the University of Illinois Midwest Latino Research and Policy Health Care Center, consisting of eight modules delivered in six weekly 90-minute sessions. Churches, senior residences and senior community centers in the communities of greatest disparities are recruited to host DSME classes. Our strategies to maximize attendance and facilitate change include:

• Work with QIO cross task teams to acquire optimal community partner referrals

• Assistance provided to the host site to effectively identify eligible participants and gather members/residents to attend classes

• Create culturally sensitive eye-catching marketing materials (flyers, posters)

• Give participants valued educational reinforcement tools as incentives to complete the program including customized cookbooks, shopping bags, pedometers and water bottles.

• Invite family members to participate in classes

• Participants fill out Patient Activation Surveys at the first and last class, to track changes in knowledge, coping skills and health behaviors

• No cost DEEP peer educator training to lay leaders and health professionals in order to strengthen and grow diabetes education in our state

Evaluation Methods and Results: Analysis of the 2015 pre and post PAS surveys demonstrate a 92% improvement in knowledge, 85% improvement in coping skills, and 69% improvement in self-management behavior. Illinois has graduated a total of 293 seniors (88% have diabetes, 12% have pre-diabetes). In the quarter ending 4/31/16, we are on target to graduate over 129 people in 3 months, having completed 11 classes during that period. We have trained 25 peer educators and are on track to train another 50 by the end of 2016. Our ultimate target is to graduate a total of 2136 individuals by 7/31/2019.

Conclusions: Through utilization of evidenced based curriculum, community outreach and peer educator training, Telligen is successfully empowering the lives of seniors living in areas of the health disparities and spreading sustainable DSME throughout the Chicagoland area and the state of Illinois.

Implications for research and/or practice: Widespread community DSME is possible when effective outreach and promotional practices are employed.