Type 2 diabetes (DM) accounts for close to 30 million cases in the United States  (Centers for Disease Control and Prevention, 2019) and remains a major public health issue. Latinos in the United States are among those facing high rates of diabetes and related costs and have one of the highest age-adjusted percentage of people 20 years or older with diabetes—12.1% compared to 7.4% of non-Hispanic whites (CDC, 2019). Due to the high prevalence, known disparities and cost of the disease, effective interventions to improve the quality of care are required to stem the morbidity and mortality and costs attributed to DM. Developing a healthcare team with active participation by all members of the team forms one potential cost saving approach to health care delivery and quality improvement. Therefore, training the front-line primary care team, including community health workers (CHWs), in chronic disease such as diabetes strengthens health care services in communities and can reduce fragmentation of care for patients. Additionally, it can  improve health education from a culturally and linguistically appropriate standpoint and save healthcare costs for people at risk for health disparities ultimately improving patient outcomes.

CHWs are trusted members of a community, enabling them to serve as a link between health and social services agencies and the community to facilitate access to services and improve the quality and cultural competence of service delivery. Additionally, CHWs build community and individual capacity by increasing health knowledge through outreach, education, counseling, social support, and advocacy.

The Project Extension for Community Healthcare Outcomes (Project ECHO) represents an effective training model for health care providers and CHWs. Developed at the University of New Mexico in 2003 as a platform to improve access to evidence-based care for underserved populations facing complex health problems, it has been utilized globally in at least 38 countries (Project ECHO, 2020). Project ECHO relies on best practices to reduce disparities, including adhering to evidence-based practice and guidelines.

To that extent, Migrant Clinicians Network utilized the Project ECHO framework to train CHWs in best practices in diabetes prevention in management. Over a series of six 90-minute session, 32 CHWs and other peer educators participated in sessions on diabetes focusing on what is diabetes, complications from the disease, including how the various systems of the body are affected,  nutrition and diabetes, diabetes treatments that include medications and improved lifestyle,  gestational diabetes, and mental health and diabetes.

This webinar will review the components of MCN’s Project ECHO series with CHWs on Diabetes. It will provide an overview of the content of the training, the use of a culturally and linguistically appropriate patient education comic book utilized both in the series and by the CHWs for patient education and discuss the value of CHW trainings in Spanish.

Lois Wessel, FNP, DNP is a professor at School of Nursing and Health Studies at Georgetown University. She practices clinically at CCI Health & Wellness in Silver Spring, MD with a focus on immigrant and refugee health. She is bilingual (English-Spanish) and is involved with numerous community and environmental health programs including the Mid-Atlantic Center for Children's Health and the Environment, Migrant Clinicians Network and the Alliance of Nurses for Healthy Environments. She was a Duke Johnson & Johnson Nurse Leadership Fellow and is a member of the editorial board for the Journal for Nurse Practitioners. Dr. Wessel's areas of interest include community health workers, Project ECHO, health literacy, environmental health, food justice, and team-based care.