Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #110346

Elizabeth A. Prezio, MD, Office for Community Health, HealthTexas Provider Network, 8080 N. Central Expressway, Suite 1700, Dallas, TX 75206, James W. Walton, DO, Medical Director, Office for Community Health, HealthTexas Provider Network, 8080 N. Central Expressway, Suite 1700, Dallas, TX 75206, and Dan Culica, MD, PhD, School of Public Health, University of Texas Health Science Center at Houston, 5323 Harry Hines Blvd., V8.300, Dallas, TX 75390, 214-648-1070, dan.culica@utsouthwestern.edu.

The unique, culturally-sensitive CoDE Program provides diabetes education to the underserved, largely Mexican-American, East Dallas community in a faith-based clinic. A specially trained bilingual community health worker, known as the “CoDE” or Community Diabetes Educator, delivers the one-to-one protocol-based intervention. The three one-hour sessions which occur during the first enrollment month stress monitoring, nutrition, lifestyle changes and long-term complications. Thereafter, five quarterly one hour sessions reinforce goals/skills. 125 patients have been enrolled over the last 18 months. HbA1C was reduced 1.7%. 41% of patients achieved a HbA1C < 7%. ADA Standards of Care were achieved in > 90% of patients for all parameters except blood pressure (85%), annual eye care (37%).

An 18 month randomized controlled trial to document the effectiveness and efficiency of CoDE is currently underway. 180 indigent diabetic patients (type 1 or 2), 18-75 years of age have been randomized to a control group (90 patients) who will receive routine medical care for diabetes, or to an experimental group (90 patients) who will participate in CoDE in addition to regular medical care. The control group is wait-listed to receive the educational intervention at the conclusion of the study. Outcomes measured include health beliefs, quality of life, health indicators (HbA1C, blood pressure, lipids, microalbumin, BMI), and cost analysis of the program. Documenting the success of this strategy will facilitate not only the maintenance of this program but also its expansion into other local clinics to improve diabetes outcomes in this community.

Learning Objectives: At the conclusion of this session, the participant in this session will be able to

• Identify the unique features of the CoDE Program
• Recognize the potential of the community health worker to act as diabetes educator
• Discuss the outcomes of the randomized controlled trial
• Discuss the importance of the faith-based setting to the success of the CoDE Program

Keywords: Diabetes, Health Education Strategies

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.