Diabetes Self-Management Education and Support (DSMES) For Underserved Group in Calexico, California

Abstract

Purpose: This practice project seeks to explore the effects of a culturally tailored Diabetes Self-Management Education and Support (DSMES) program and its interventions on medication adherence and self-efficacy for a cohort of Hispanic adults 18 years and older who have been diagnosed with T2DM in Calexico. The aim is to establish DSMES as an effective intervention to increase knowledge and adherence. Background: Type 2 Diabetes mellitus (T2DM) continues to be a public health crisis in underserved communities such as Calexico, California. The communities’ lack of access to care, language barriers, and low health literacy has led to poor glycemic control and high prevalence of diabetes related complications. Methods: The quality improvement (QI) project will follow the Plan-Do-Study-Act (PDSA) framework. Recruitment will be done through an established diabetes education program. A 20-minute in-person, bilingual DSMES session will be conducted with health literacy-sensitive materials. Tools such as the Diabetes Self-Management Questionnaire (DSMQ) and the Medication Adherence Report Scale (MARS-5) will be used before the interventions. This study is consistent with Orem’s Self-Care Theory, and it facilitates the incorporation of DSMES into rural primary care. Results: Six patients were enrolled in a single session day; all provided consent, completed both surveys, and spoke Spanish. Median duration since T2DM diagnosis was 7.5 years. The average adherence increased from 4.08 during the pre-education phase to 5.00 after the education phase. The mean within-person shift was +0.92 points on the 1–5 scale, a statistically reliable gain (paired t(5) =8.88, p=0.00030). Conclusions: A single point-of-care, Spanish-only DSMES session integrated into the regular clinic flow was feasible and acceptable and led to an early clinically significant improvement in self-reported medication adherence among Hispanic adults with longstanding T2DM.