The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #64991

Scott Wolf, DO, MPH¹, Noemi Cruz, RD, CDE², Julia D. Portale, MPH, MBA³, Kenneth S Babamoto, PharmD, MPH³, Sheryl Horowitz, PhD¹, Vicki J Karlan, MPH⁴, and Angela J Camilleri, MPH, MA³. (1) Department of Medicine, Hartford Hospital, 80 Seymour Street, P.O. Box 5037, Hartford, CT 06102, (2) Program Coordinator, Hartford Hospital, 79 Retreat Avenue, Brownstone Bldg. 110, Hartford, CT 06102, 860-545-4195, ncruz@harthosp.org, (3) Community Health, Pfizer Health Solutions, 235 East 42nd Street (150/37/5), New York, NY 10017, (4) Outcomes and Analytics, Pfizer Health Solutions, 2400 Broadway, Suite 500, Santa Monica, CA 90404

Hispanics now comprise the largest minority group in the US, representing approximately 37 million residents. With this growth, the prevalence of diabetes and pre-diabetes is a major health epidemic among Hispanics. Nationally, Hispanics are almost twice as likely as non-Hispanic whites to have diabetes. In Hartford, Connecticut, over 12% of Hispanic residents suffer from diabetes compared to 6.5% statewide. In response, Hartford Hospital, a teaching and tertiary care center, partnered with Pfizer Health Solutions to implement 'Amigos en Salud'. This is a clinic-based, randomized, controlled study comparing the effectiveness of trained community health workers (CHW) with usual care. Working alongside clinic physicians and a registered dietician/diabetes educator, the CHWs provide culturally relevant, stage of change-based health education and support for Hispanics diagnosed with diabetes. Over 300 participants will be enrolled for 12 months to formally evaluate the CHW intervention that incorporates Healthy People 2010 goals, ADA Clinical Practice Recommendations and self-management skills. Since July 2002, over 889 Hispanics have been screened to determine eligibility for enrollment. Of those who provided data, mean age was 52 years, 87% reported Puerto Rican decent, 71% have < high school education, and 98% have a household income < $25,000. Baseline health behavior findings reveal 66% exercise < 3 times a week, and 33% smoke cigarettes. When asked about health status, 77% rated their current health as “fair” or “poor”. Baseline clinical values indicate that 48% have hypertension and 66% have an A1c value > 7%. Program implementation, education intervention, and results will be presented.

Learning Objectives:

• Describe 3 key issues associated with health disparities among Hispanics with diabetes.
• Identify 2 major health outcomes used to evaluate the effectiveness of a collaborative hospital-based diabetes self-management program.

Keywords: Diabetes, Self-Management

Presenting author's disclosure statement:
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: PI of Study