A clinic-based pilot intervention to enhance diabetes management for elderly Hispanic patients.
OBJECTIVE
Successful diabetes self-management requires behavioral and lifestyle changes. However, low-income patients may face challenges related to poverty that make it difficult to engage in lifestyle changes. We piloted an intervention designed to help older, low-income, Hispanic, patients with diabetes access free or low-cost community resources to enhance diabetes self-management. Results from this pilot intervention are reported.


METHODS
Patients were recruited at baseline to complete surveys assessing diabetes self-care activities, diabetes self-efficacy, and general self-efficacy. Volunteers were trained by a clinic social worker to help patients identify needs and make referrals to local community resources (e.g., housing, transportation, food, clothing, dental and prescription services, employment, or family social services). Identical surveys were administered at 3-month follow-up.


RESULTS
28 patients were recruited at baseline and 18 patients completed the follow-up assessment. No significant changes in diabetes care and self-efficacy were detected. All patients requested at least one referral to a community resource. The most common requests were for low-cost dental clinics, food assistance, and housing support. At follow-up, nine (50%) patients contacted their given referrals.


CONCLUSIONS
The need for assistance with basic social services is high in this population. The rate of referral uptake (50%) is high for a relatively low intensity intervention. Since the completion of the pilot, the program has trained 21 volunteers and helped over 220 patients in a primary care clinic. Using a volunteer model and creating connections to existing community resources is a cost-conscious way to deliver needed services to patients.
USC Keck School of Medicine Department of Family Medicine, 1000 South Fremont Ave, unit 22, Alhambra, CA 91803.
Annie L
AL
Nguyen
UC, Irvine, Department of Family Medicine, 101 The City Drive South Building 200, Suite 835, Orange, CA 92868.
Marco
M
Angulo
UC, Irvine, Department of Family Medicine, 101 The City Drive South Building 200, Suite 835, Orange, CA 92868.
Linda L
LL
Haghi
UC, Irvine, Department of Family Medicine, 101 The City Drive South Building 200, Suite 835, Orange, CA 92868.
Maya
M
Cruz
UC, Irvine, Department of Family Medicine, 101 The City Drive South Building 200, Suite 835, Orange, CA 92868.
Nahal
N
Nikroo
UC, Irvine, Department of Family Medicine, 101 The City Drive South Building 200, Suite 835, Orange, CA 92868.
Sarah
S
Peraza
UC, Irvine, Department of Family Medicine, 101 The City Drive South Building 200, Suite 835, Orange, CA 92868.
Justin
J
Bennink
UCLA Department of Medicine, Division of General Internal Medicine/Health Services Research, 10940 Wilshire Blvd, Suite 700 Los Angeles, CA 90024.
O Kenrik
OK
Duru
UCLA Department of Medicine, Division of Geriatrics 10945 Le Conte Blvd, Suite 2339, Los Angeles, CA 90095.
Alison A
AA
Moore
USC Keck School of Medicine Department of Family Medicine, 1000 South Fremont Ave, unit 22, Alhambra, CA 91803.
Laura A
LA
Mosqueda