Strategies for implementing a promotores-led diabetes self-management program into a clinic structure.
The purpose of this article is to describe a process for integrating promotores who teach diabetes self-management into a community clinic structure.



The Donbedian structure, process, and outcome methodology was used to integrate promotores into a community clinic.



The model described here resulted in (1) employment of promotores (community health workers) to teach diabetes self-management courses, (2) integration of provider and nurse oversight of course design and implementation, (3) management of promotora training and the development of teaching competencies and skills, (4) coordination of care through communication and documentation policies and procedures, (5) use of quality control mechanisms to maintain patient safety, and (6) promotion of a culturally competent approach to the educational process.



The model presented here provides a systematic approach to safely address the educational needs of large numbers of patients with type 2 diabetes who live in communities that suffer from a lack of health care professionals.
Sixta
Constance S
CS
The School of Nursing, University of Texas Health Science Center, Houston (Dr Sixta, Dr Ostwald)|Sixta Consulting Inc, Pearland, Texas (Dr Sixta)
Ostwald
Sharon
S
The School of Nursing, University of Texas Health Science Center, Houston (Dr Sixta, Dr Ostwald)
D002487:Centers for Disease Control and Prevention, U.S.; D003695:Delivery of Health Care; D003920:Diabetes Mellitus / Q000523:psychology / Q000534:rehabilitation / Q000628:therapy*; D015438:Health Behavior; D006293:Health Promotion; D010353:Patient Education as Topic; D012648:Self Care; D012944:Social Support; D014481:United States; D000078329:Workforce