A quality initiative to improve primary care self-management education for Mexican American type 2 diabetes patients using a culturally-tailored protocol

Type 2 diabetes mellitus is the fifth leading cause of death among the Hispanic population in America. Current data estimates up to 50% of all Hispanics born in 2000 will develop diabetes within their lifetime. Factors leading to diabetes or diabetes related complications in Hispanic patients are low English proficiency, low literacy levels, and cultural influences. A vital component to diabetes treatment is self-care behaviors. Elements vital in providing effective diabetes education should incorporate services that are person-centered, culturally relevant, and responsive to the participants’ needs. The purpose of this quality improvement initiative was to increase clinical compliance with diabetes guidelines to provide timely and culturally competent diabetes self-management education and improve diabetes knowledge, self-management behaviors, and health outcomes in Mexican American patients with diabetes at a primary care clinic in East Texas, using an customized education protocol. The protocol addressed language and literacy barriers, as well as appealing to social norms with the assistance of bilingual translators, educational handouts, and telenovela diabetes educational videos created by the Agency for Healthcare Research and Quality. This quality initiative used a pre-test, post-test design to implement a change in practice instituting an improved protocol for delivering DSME to Mexican American patients with diabetes at project site over a 12-week period. The implementation of the DSME protocol at the project site resulted in a large and statistically significant increase in the frequency and quality of DSME provided by the clinic and improved patients’ knowledge of diabetes and reported management activities.