NY QIO Empowers Minority Communities to Better Manage Diabetes

While 23.5[1] million adult Americans live with diabetes, rates of the disease are disproportionately higher in minority populations. The Centers for Medicare & Medicaid Services (CMS) established the Every Diabetic Counts (EDC) program to address this health disparity. Through EDC, six Quality Improvement Organizations (QIOs) are delivering diabetes self-management education to medically underserved Medicare beneficiaries in communities across the country. 

IPRO, the QIO for New York State, has taken on the challenge of educating 2,500 Medicare beneficiaries in America’s largest metropolitan area. One in eight New York City residents has diabetes and nearly 60 percent of those individuals are African-American or Hispanic.

Community Outreach

EDC’s community-based design means that each participating QIO must forge partnerships with other organizations that serve Medicare beneficiaries to promote and provide diabetes self-management education. IPRO’s network of partners includes hundreds of senior centers, faith-based and community organizations, as well as health coalitions, state and local government agencies, and professional organizations.

These community partners endorse EDC and support recruitment by helping IPRO make face-to-face contact with underserved beneficiaries. IPRO also holds its Diabetes Wellness Workshops—what it calls the self-management education—at partner locations. This offers beneficiaries both convenience and comfort; the courses are not only taught in their neighborhood, they are also held in familiar settings. To further generate awareness and interest, IPRO recently started working with two radio stations, one that targets the African-American audience and one that targets the Hispanic audience.

Diabetes Wellness Workshops

IPRO’s Diabetes Wellness Workshops consist of six weekly sessions that last approximately two and a half hours each. Each class has up to 20 participants. IPRO is using two curricula: the Diabetes Education Empowerment Program, which was developed at the University of Illinois at Chicago Midwest Latino Health Research Training and Policy Center; and the Diabetes Self-Management Program, which was developed at the Stanford Patient Education Research Center.

Workshop sessions cover such topics as the human body, diabetes and its risk factors, monitoring your body, physical activity and exercise, nutrition, identifying and preventing complications, medication and medical care, and enlisting support from family and friends. In order to graduate, beneficiaries must attend four of the six total classes and complete pre-and post-surveys.

Sensitivity to Medically Underserved Populations

One of IPRO’s goals is to offer a program that honors and accommodates the cultural values and life experiences of participants. Because so many participants are Spanish speaking, IPRO created bilingual marketing and educational materials that supplement the two curricula and offers diabetes self-management classes in Spanish.

From recruitment brochures to websites, every aspect of the program is available in English and Spanish, allowing the Hispanic community full access to health-education resources. The numerous letters of appreciation sent to IPRO by participants affirm the campaign’s positive impact on their quality of life, including new health habits and better blood sugar control.

Because visual impairment is a complication of diabetes, IPRO is providing Diabetes Wellness Workshops for the visually impaired, graduating all 23 beneficiaries who enrolled in one of the two workshops held earlier this year.

Looking Ahead

IPRO conducts ongoing quantitative evaluations to closely follow EDC participants’ progress and measure the impact of the classes. Beneficiaries begin the EDC program by completing a survey to assess their skills in diabetes self-management. Upon graduation, they complete an exit survey to gauge skills gained during the six-week course. IPRO’s certified diabetes educator is helping to reinforce the long-term gains of the program by following up with approximately ten percent of the graduates, who note that they continue to use skills acquired during the workshops.

“It is extremely rewarding to be part of something that has such a measurable impact on so many lives,” said Janice Hidalgo-Meléndez, project manager of IPRO’s EDC program.

To date, the New York EDC program has graduated approximately 1,900 Medicare beneficiaries; 60 percent are African-American and 40 percent are Hispanic. The five other QIOs implementing the EDC program—Georgia, Louisiana, Maryland, Virgin Islands and Washington, D.C. — have trained an additional 6,300 beneficiaries with diabetes to better manage their disease.