APRN-Led Culturally Tailored Diabetes Self-Management Education (DSME) for Spanish-Speaking Hispanic Americans (SSHAs)

Type 2 diabetes mellitus disproportionately affects ethnic minorities in the United States, including Hispanic Americans, and incurs a costly disease burden. This APRN-led project implemented a culturally tailored Diabetes Self-Management Education (DSME) program for Spanish-speaking Hispanic Americans (SSHAs) using medically-trained, bilingual, bicultural interpreters (BBIs) and the Diabetes Conversation Map™. Eight SSHAs with hemoglobin A1c (HbA1c) over 7.0% were recruited to participate in the one-day DSME program. Program evaluation was accomplished using pretest/posttest measures of diabetes knowledge, self-efficacy, HbA1c, and program satisfaction. Bilingual, bicultural interpreters (BBIs) guided participants through the translated Diabetes Conversation Map™, “On the Road to Better Managing Your Diabetes,” an engaging tool that facilitates learning through group conversation. The APRN leader incorporated a family-style approach and provided diabetes-friendly snacks. Low literacy take-home handouts depicted familiar carbohydrates and appropriate portion sizes. In this predominantly female sample from primarily El Salvador and Mexico (75% female, mean age 52), diabetes knowledge improved (Wilcoxon Signed Ranks Test, z=-2.041, p=.041); self-efficacy (p=.176) did not change. HbA1c was measured prior to the one day class and again three months later; HbA1c (p=.854) did not change significantly. Patient satisfaction was high at 4.839/5 (96.8%), an indication of active engagement. This APRN-led team of RNs and BBIs provided effective culturally-tailored DSME for this sample of SSHAs. Future longitudinal evaluation will examine relationships between knowledge and self-efficacy, participant satisfaction and program attendance, and HbA1c to identify DSME factors associated with reduced diabetes burden in this vulnerable population.