Racial, ethnic and other minority populations are at a higher risk for diabetes, which is more common among those living in rural communities. Compared to the 9.4 percent median county-level prevalence of diagnosed diabetes in the United States, Hendry County, Florida, has a diabetes prevalence of nearly 14 percent, putting Medicare beneficiaries living there at increased risk of heart attack and stroke, kidney disease and lower extremity amputations.
HSAG, the Quality Innovation Network-Quality Improvement Organization (QIN-QIO) for Arizona, California, Florida, Ohio and the U.S. Virgin Islands, is equipping pastors and health ministers to deliver diabetes self-management education to African-American Medicare beneficiaries in Florida through its partnership with the Progressive Missionary Baptist Church Conference.
The doors to this partnership opened through a grassroots effort that began in 2014 with HSAG staff approaching known church families, attending pastor breakfasts, and using word-of-mouth to launch diabetes classes and recruit diabetes peer educators within the church communities. Churches, HSAG learned, are often the support networks for people living throughout the state and particularly in rural areas of Florida. As pastors and health ministers found out about HSAG’s diabetes training for congregants, they contacted pastors and health ministers at fellow churches to let them know about this valuable resource.
“Developing this partnership has been a long process, and we’ve had to be persistent,” said Laura Gamba, CBA, BA, director and senior trainer for the Diabetes Education Empowerment Program™, at HSAG. “We’re starting to see our hard work pay off.
HSAG’s persistence was rewarded when its staff met a pastor considered to be a leader within the church community, whose personal connections led to a meeting for HSAG with the Church Conference. That meeting led to an invitation to the Church Conference’s five-day annual meeting in Panama City.
“As a result of this learning experience, many churches stepped up and asked for training for their pastors and health ministers.”
At that meeting, HSAG provided peer educator training to pastors and health ministers. The training included an overview of HSAG, the QIO Program’s Everyone with Diabetes Counts Program, and coaching on the DEEP™ model—one of two evidence-based Diabetes Self-Management Education (DSME) curricula. To make the training more engaging, HSAG offered experiential learning by demonstrating the DEEP™ model, so pastors and health ministers could experience what church members would as DSME class participants.
“As a result of this learning experience, many churches stepped up and asked for training for their pastors and health ministers,” said Gamba.
The training was so well received that HSAG was invited to provide the Church Conference with DEEP’s™ three-day train-the-trainer session at a smaller regional meeting. Because many pastors and health ministers attending those meetings were also leading breakout sessions, they couldn’t participate, so HSAG extended invitations to them to attend one of the QIN-QIO’s three-day train-the-trainer sessions offered throughout the state.
Now, HSAG is focused on expanding peer educator training to churches from central Florida down to the Keys and up through rural areas of the Panhandle. HSAG has also offered peer education training sessions throughout the Panhandle, as needed, to help reduce travel costs for churches.
Church conferences represent churches throughout expansive geographic areas, including disenfranchised rural areas. Working at the local level with individual churches provides immediate opportunities to increase DEEP class outcomes. Efforts at the Church Conference level have resulted in greater spread and sustainability, as churches in regional areas understand the need for health ministers trained as DEEP peer educators to provide diabetes training to their own congregations, as well as to other regional congregations without health ministries. HSAG has also created and uses a variety of faith-based outreach documents, designed to be personalized by local trainers, to assist with recruitment and enrollment.