title: Building capacity to reduce disparities in diabetes: training community health workers using an integrated distance learning model.
abstract: The purpose of this study is to determine whether an innovative interactive distance training program is an effective modality to train community health workers (CHWs) to become members of the diabetes health care team. The University of New Mexico Health Sciences Center has developed a rigorous diabetes training program for CHWs involving both distance and hands-on learning as part of Project ECHO™ (Extension for Community Healthcare Outcomes).
  
  
  
  Twenty-three diverse CHW participants from across New Mexico were enrolled in the first training session. Participants completed surveys at baseline and at the end of the program. They attended a 3-day hands-on training session, followed by weekly participation in tele/video conferences for 6 months. Wilcoxon signed-rank statistics were used to compare pre- and posttest results.
  
  
  
  Participants demonstrated significant improvements in diabetes knowledge (P = .002), diabetes attitudes (P = .04) and confidence in both clinical and nonclinical skills (P < .001 and P = .04, respectively). Additionally, during focus group discussions, participants reported numerous benefits from participation in the program.
  
  
  
  Community health worker participation in the Project ECHO diabetes training program resulted in significant increases in knowledge, confidence, and attitudes in providing care to patients with diabetes. Studies are ongoing to determine whether the training has a positive impact on patient outcomes.
authors.affiliation: University of New Mexico Health Sciences Center, Department of Internal Medicine, Albuquerque, NM
authors.forename: Kathleen
authors.initials: K
authors.lastname: Colleran
authors.affiliation: University of New Mexico Health Sciences Center, Department of Internal Medicine, Albuquerque, NM
authors.forename: Erika
authors.initials: E
authors.lastname: Harding
authors.affiliation: University of New Mexico School of Medicine, Center for Native American Health, Albuquerque, NM
authors.forename: Billie Jo
authors.initials: BJ
authors.lastname: Kipp
authors.affiliation: University of New Mexico Health Sciences Center, Patient Education, Albuquerque, NM
authors.forename: Andrea
authors.initials: A
authors.lastname: Zurawski
authors.affiliation: University of New Mexico Health Sciences Center, Patient Education, Albuquerque, NM
authors.forename: Barbara
authors.initials: B
authors.lastname: MacMillan
authors.affiliation: University of New Mexico Health Sciences Center, Department of Internal Medicine, Albuquerque, NM
authors.forename: Lucie
authors.initials: L
authors.lastname: Jelinkova
authors.affiliation: University of New Mexico Health Sciences Center, Office of Program Evaluation, Education and Research Albuquerque, NM
authors.forename: Summers
authors.initials: S
authors.lastname: Kalishman
authors.affiliation: University of New Mexico Health Sciences Center, Office of Program Evaluation, Education and Research Albuquerque, NM
authors.forename: Denise
authors.initials: D
authors.lastname: Dion
authors.affiliation: University of New Mexico Health Sciences Center, Department of Internal Medicine, Albuquerque, NM
authors.forename: Dara
authors.initials: D
authors.lastname: Som
authors.affiliation: University of New Mexico Health Sciences Center, Department of Internal Medicine, Albuquerque, NM
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Arora
mesh_terms: D000328:Adult; D057191:Capacity Building; D003153:Community Health Services / Q000458:organization & administration*; D003150:Community Health Workers / Q000193:education*; D055812:Community-Based Participatory Research; D003920:Diabetes Mellitus / Q000453:epidemiology; D020375:Education, Distance; D005260:Female; D054625:Healthcare Disparities / Q000639:trends*; D006801:Humans; D008875:Middle Aged; D009516:New Mexico / Q000453:epidemiology; D010348:Patient Care Team; D010353:Patient Education as Topic