Local initiatives educate Latinos about diabetes

9/16/2009, 4:47 a.m.
Margarita Persico Juan Humberto Perez, a chef for...

Perez, also an artist who paints about the Red Sox, said he had never been offered formal diabetes education classes. When he found out the Joslin Diabetes Center’s Latino Diabetic Initiative had such an education program, he switched doctors to take advantage.

He recalls how out of control his blood sugar had been. The ideal blood sugar level is under 100 milligrams of glucose per deciliter of blood. One day, his was nearly 300 milligrams per deciliter. He decided to take 10 additional units of insulin, even though he knew he was taking a risk.

“My sugar never goes up that high,” said Perez.

Later, at the diabetes management classes, Perez learned that injectable insulin expires 30 days after opening.

Both MGH and Joslin’s Latino Diabetes Initiative are trying to get this kind of information to local Latino communities. Joslin has developed a series of culturally tailored programs with educational tools such as the DSME classes, exercise groups, grocery shopping tours and even an audio soap opera.

It is important to take into consideration health literacy levels, or the ability people have to comprehend health care messages, according to Caballero. He says health messages and materials need to be appropriate for each patient’s literacy level.

The Joslin Latino Diabetes Initiative has several culturally oriented strategies to educate their population. One of them is “La Historia de Rosa (Rosa’s Story),” an audio novella CD, recorded in Spanish and designed for patients with low health literacy. This tool educates not only the patients, but also their families about diabetes’ basic care and prevention, said Caballero.

“[‘Rosa’s Story’] conveys the message on what they need to do in terms of their diabetes, their nutrition, their exercise, their medications, glucose testing [and] diabetes prevention in a very practical, interesting, funny way,” said Caballero.

But the Joslin initiative, which started in 2002, recognizes patients’ need for more educational resources.

“One example of our culturally oriented activities is that we just created a pilot [program] of salsa dancing,” said Caballero. “Many of our patients said they … didn’t like to run or jog, but that they would dance.”

That led Caballero and his team to hire a salsa instructor for a monthly meeting with his patients at Boylston Congregational Church in Jamaica Plain.

“We all get together with the patients, and we dance for a little bit,” said Caballero. “And we take that opportunity to also convey some educational messages of what to do with their diabetes, how to improve their care.”

The approach has earned praise within the field. Caballero and his team were the recipients of the National Minority Quality Forum’s 2009 Bernardo Alberto Houssay award for their work with minority and underserved populations.

Another strategy that Joslin educators have used is conducting supermarket tours to educate their low-income patients on how to purchase healthy food within their budget.

“Sometimes healthier foods are more expensive, but not all the time,” said Caballero. “So even within a limited budget, people can make better choices. And so now we go exactly to where people buy the food and teach people how to do that in a better way.”