Evidence-level

Effective (About evidence-level criteria)

Description

LA VIDA (Lifestyle and Values Impacting Diabetes Awareness) was a community-based chronic disease intervention program using community health workers (CHWs) to help those who have diabetes or are at risk of developing diabetes. The program was offered by Hidalgo Medical Services as part of its broader Family Support Services, aimed at reducing health disparities and improving the health status of residents in Grant and Hidalgo counties in southwest New Mexico.

The development of LA VIDA was funded by a REACH (Racial and Ethnic Approaches to Community Health) grant from the Centers for Disease Control and Prevention.

Currently, LA VIDA is not being offered on a large, community-wide scale. Its principles now are used by Provider-Integrated Care Team Coordinators (community health workers). This staff addresses social determinants of health and provides education and support to patients in need of prediabetes/diabetes education as identified by the care team.

Family Support staff members receive on-the-job training, including shadowing experienced staff. They also attend training workshops such as diabetes education classes and classes covering topics such as cultural competency, motivational interviewing, and customer service.

Services offered

To support people with chronic diseases and meet community needs, LA VIDA and its CHWs offered:

• Enrollment services for free or low-cost insurance programs
• Assistance accessing health and social services
• Information and support for healthy eating
• One-on-one diabetes education
• Outreach to other organizations about Family Support Services

The current CHW program offers the above services, but diabetes education is no longer one-on-one and the outreach to other organizations is now community outreach.

Results

The results below reflect the full-scale implementation of LA VIDA:

• LA VIDA participants with diabetes increased the number of days they checked their feet and took their diabetes medications. They also lowered their glycated hemoglobin levels (HbA1C).
• LA VIDA participants overcame cultural barriers to diabetes control and showed empowerment and self-efficacy related to managing their diabetes.
• LA VIDA's CHWs served approximately one-fourth of the area's population each year. In 2010, CHWs provided 58,000 services to 5,700 clients.
• CHWs distributed food to more than 300 families in rural communities.
• The program helped change policies to reduce the number of vending machines in area schools, in partnership with other community organizations.
• LA VIDA partnered with the Grant County Health Council to create a local Food Policy Council.
• 34% of Grant and Hidalgo county restaurants participated in the Viva New Mexico Restaurant Program by offering healthy menu options to the community.

For more information about program results:

McCloskey, J., Tollestrup, K., & Sanders, M. (2011). A Community Integration Approach to Social Determinants of Health in New Mexico. Family and Community Health, 34(Suppl 1), S79-91. Article Abstract

McCloskey, J. & Flenniken, D. (2010). Overcoming Cultural Barriers to Diabetes Control: A Qualitative Study of Southwestern New Mexico Hispanics. Journal of Cultural Diversity, 17(3), 110-115. Article Abstract

McCloskey, J. (2009). Promotores as Partners in a Community-Based Diabetes Intervention Program Targeting Hispanics. Family and Community Health, 32(1), 48-57. Article Abstract

The current CHW program has no direct results, but the CHWs have partnered with the University of New Mexico's Office of Community Health on their research studies related to CHW interventions and health outcomes.

Challenges

Sustainable funding is a barrier to continuing any large-scale initiative.

Services provided by CHWs are non-reimbursable by managed care organizations that administer Medicaid in New Mexico.

Replication

The key to LA VIDA's initial success was strong community collaborations and a steady funding stream.

Contact Information

Hidalgo Medical Services