Training community health promoters to implement diabetes self-management support programs for urban minority adults.
To develop, implement, and evaluate a peer-led diabetes self-management support program in English and Spanish for a diverse, urban, low-income population. The program goals and objectives were to improve diabetes self-management behaviors, especially becoming more physically active, healthier eating, medication adherence, problem solving, and goal setting.



After a new training program for peers led by a certified diabetes educator (CDE) was implemented with 5 individuals, this pilot evaluation study was conducted in 2 community settings in the East and South Bronx. Seventeen adults with diabetes participated in the new peer-led 5-session program. Survey data were collected pre- and postintervention on diabetes self-care activities, quality of well-being, and number of steps using a pedometer.



This pilot study established the acceptance and feasibility of both the peer training program and the community-based, peer-led program for underserved, minority adults with diabetes. Significant improvements were found in several physical activity and nutrition activities, with a modest improvement in well-being. Feedback from both peer facilitators and participants indicated that a longer program, but with the same educational materials, was desirable.



To reduce health disparities in urban communities, it is essential to continue program evaluation of the critical elements of peer-led programs for multiethnic adults with diabetes to promote self-management support in a cost-effective and culturally appropriate manner. Practice Implications A diabetes self-management support program can be successfully implemented in the community by peers, within a model including remote supervision by a CDE.
Comellas
Mariceli
M
Teachers College, Columbia University, New York (Ms Comellas)
Walker
Elizabeth A
EA
Albert Einstein College of Medicine, Bronx, New York (Dr Walker, Dr Zonszein)
Movsas
Sharon
S
Montefiore Medical Center, Bronx, New York (Ms Movsas, Ms Merkin, Dr Strelnick)
Merkin
Sheryl
S
Montefiore Medical Center, Bronx, New York (Ms Movsas, Ms Merkin, Dr Strelnick)
Zonszein
Joel
J
Albert Einstein College of Medicine, Bronx, New York (Dr Walker, Dr Zonszein)
Strelnick
Hal
H
Montefiore Medical Center, Bronx, New York (Ms Movsas, Ms Merkin, Dr Strelnick)
D000328:Adult; D001294:Attitude to Health; D002568:Certification; D003150:Community Health Workers / Q000193:education*; D003479:Curriculum; D003920:Diabetes Mellitus / Q000523:psychology / Q000534:rehabilitation*; D006293:Health Promotion; D006801:Humans; D008913:Minority Groups; D010865:Pilot Projects; D012648:Self Care