An online diabetes education program has resulted in declining hemoglobin A1c levels among participants in pilot tests, according to the program's sponsor.
Pfizer Health Solutions Inc. recently made Amigos en Salud (Friends in Health), its diabetes education program, available online free of charge at www.amigosensalud.com
Results across the pilot sites showed statistically significant improvements in clinical, behavioral, and mental health outcomes among individuals enrolled in Amigos en Salud, compared with patients who received usual care. For example, in the Los Angeles pilot, which was conducted between 2002 and 2004, the average hemoglobin A1c level among participants decreased from 8.6% at baseline to 6.9% at follow-up.
The Amigos en Salud program targets Hispanic and African American patients in an effort to help reduce health disparities, according to Pfizer Health Solutions.
Diabetes disproportionately affects individuals in those groups, and many minority patients seek care in community health center settings. Of the individuals who visit community health centers, 36% are Hispanic and 23% are African American, according to statistics from the National Association of Community Health Centers.
The online materials are available in English and Spanish and can help community health centers and other organizations to implement low-cost education programs that rely primarily on community health workers.
The idea behind providing these educational materials is not to replace the care provided by physicians and nurses but to add another layer.
The community health worker is usually a layperson who serves as a liaison between the patient and the health care system—connecting patients with transportation and other resources, educating them about their disease, and helping them to make lifestyle changes that may help reduce the severity of their disease and increase their level of health.
The community health worker is generally from the same community or cultural background as the patient, helping to eliminate some of the common barriers to quality care.
“It really made my job a lot easier,” said Maria Castellanos, clinical nurse-manager at the Center for Clinical Research Excellence at Charles R. Drew University of Medicine and Science, Los Angeles, who participated in the Los Angeles pilot of Amigos en Salud.
The community health workers were able to communicate with patients more frequently and keep the patient connected to the health care system, she said, giving her more time to focus on other issues, including addressing depression among the diabetes patients.
The program was also popular with patients, Ms. Castellanos said. Over time, she found that patients were more willing to confide in the community health worker about nonmedical issues that could affect their care, such as financial or legal challenges.
The online program provides detailed instructions on how to recruit and train community health workers, implement a program, and measure the results. It also provides materials including a program graduation tool kit, a database for program evaluation, and advice on how to publicize the program locally.
The Web site also provides educational handouts in both English and Spanish on a variety of health topics including high blood pressure, high cholesterol, healthy eating, exercise, smoking cessation, and depression. The site also features tools for keeping a food diary and a blood glucose log.