Kunz Susan, Ingram Maia, Piper Rosalinda, Wu Tianne, Litton Nina, Brady Joanne, Knudson Alana
1 Mariposa Community Health Center, Nogales, AZ, USA.
2 Arizona Prevention Research Center, Tucson, AZ, USA.
Health Promot Pract. 2017 Nov;18(6):798-805. doi: 10.1177/1524839917712730. Epub 2017 Jul 3.
Diabetes disproportionately affects racial and ethnic minorities, rural, and impoverished populations. This case study describes the program components and key lessons learned from implementing Vivir Mejor! (Live Better!), a diabetes prevention and management program tailored for the rural, Mexican American population. The program used workforce innovations and multisector partnerships to engage and activate a rural, mostly Hispanic population. Community health worker (CHW) roles were designed to reach and support distinct populations. Promotoras focused exclusively on health education and patient navigators individually coached patients with chronic disease management issues for the high-risk patient population. To extend diabetes health education to the broader community in Santa Cruz County, promotoras trained lay leaders to become peer educators. Multisector partnerships allowed the program to offer health and social services around diabetes care. The partners also supported provider engagement through continuing education workshops and digital story screening to encourage referrals to the program. Multisector partnerships, including partnering with critical access hospitals, for diabetes management and prevention, as well as using different types of CHWs to implement programs that target high- and low-risk populations are innovative and valuable components of the Vivir Mejor!
糖尿病对少数族裔、农村和贫困人口的影响尤为严重。本案例研究描述了“Vivir Mejor!（活得更好！）”项目的组成部分以及实施该项目所获得的关键经验教训。“Vivir Mejor!（活得更好！）”是一个专门为农村墨西哥裔美国人量身定制的糖尿病预防和管理项目。该项目利用劳动力创新和多部门伙伴关系来吸引和动员农村地区、主要为西班牙裔的人群。社区卫生工作者（CHW）的角色旨在覆盖并支持不同人群。健康促进员专门负责健康教育，而患者导航员则为高危患者群体中患有慢性病管理问题的患者提供个性化指导。为了将糖尿病健康教育扩展到圣克鲁斯县更广泛的社区，健康促进员培训外行人成为同伴教育者。多部门伙伴关系使该项目能够围绕糖尿病护理提供健康和社会服务。合作伙伴还通过继续教育研讨会和数字故事放映来支持医疗服务提供者参与其中，以鼓励他们将患者转介到该项目。多部门伙伴关系，包括与急救医院合作进行糖尿病管理和预防，以及使用不同类型的社区卫生工作者来实施针对高风险和低风险人群的项目，是“Vivir Mejor!（活得更好！）”项目创新且有价值的组成部分。
