Implementation and evaluation of a low health literacy and culturally sensitive diabetes education program.

Low health literacy is more prevalent in persons with limited education, members of ethnic minorities, and those who speak English as a second language, and is associated with multiple adverse diabetes-related health outcomes. This study examined the effectiveness of a low health literacy and culturally sensitive diabetes education program for economically and socially disadvantaged adult patients with type 2 diabetes. A pre-post prospective study design was used to examine outcomes over 12 months. Outcome measures included diabetes knowledge, self-efficacy, and self-care, measured using reliable and valid survey tools, and A1C. Over this period of time 277 patients were enrolled in the program, with 106 participants completing survey data. At the completion of the program patients had significant improvements in diabetes knowledge (p < .001), self-efficacy (p < .001), and three domains of self-care including diet (p < .001), foot care (p < .001), and exercise (p < .001). There were no significant improvements in the frequency of blood glucose testing (p = .345). Additionally, A1C values significantly improved 3 months after completing the program (p = .007). In conclusion, a diabetes education program designed to be culturally sensitive and meet the needs of individuals with low health literacy improves short-term outcomes.

Understanding the role of the promotora in a Latino diabetes education program.

We explore the role of the promotora de salud (health promoter) who provided diabetes self-management education to Puerto Rican diabetics in her community. The education program was developed as a hospital and community-based organization partnership. Information from both Spanish-language focus groups with 35 class participants and an in-depth interview with the promotora indicated patients appreciated having the classes taught in Spanish by a Latina promotora from their community. Respondents reported satisfaction with the program, increased ability to self-manage diabetes, and strengthened connections with other Latino diabetics. Terms patients used for the promotora included comadre, hijita, and buena profesora. Some of these words denote almost kinship-level connections, suggesting that patients were forming strong connections with the promotora. Specific promotora roles were identified but varied among patients, promotora, and the literature. This hospital and community-based organization partnership promotora model appears to be effective for providing chronic disease self-management education in an urban community setting.

Diseño y ejecucion de planta externa para la central norte de la Cooperativa de Telefonos La Paz

El objeto del proyecto, es la construccion de planta externa para la central norte, con la finalidad de digitalizar toda la Red perteneciente a la Zona Norte y ademas poder atender la lista de espera de instalaciones nuevas y traslados. Para realizar este trabajo se construira toda una nueva Red que comprende Canalizacion, Red subterranea, Red aerea y Red de abonados. El numero total de puntos de instalacion, que incluye reservas, es de 12000 en el distribuidor principal (MDF), distribuidos en una Red directa, quince armarios y reservas. Ubicacion del proyecto.- El proyecto como su nombre lo indica, esta ubicado en la Zona Norte de la ciudad de La Paz y limita con las areas de central:Rosario, socabaya y AGF por el oeste, con la central Chacaltaya por el norte y con la Central Miraflores por el sur. Situacion actual.- La Zona Norte en la actualidad cuenta con 5320 lineas en funcionamiento donde, 5020 estan conectadas a la central Vicente Brugaleta y la Central Gran Centro, 300 son lineas inalambricas y tiene una lista de espera de aproximadamente 2000 lineas para instalaciones nuevas y traslados. Alternativas para la canalizacion.-Para construir la Red se analizaron dos alternativas para la canalizacion una de ellas utilizar la canalizacion existente y la segunda construir una nueva canalizacion. De las dos alternativas se opto por la segunda, para evitar maltratar la red existente, en funcionamiento, en el proceso de construccion y porque la canalizacion antigua tiene diferentes tipos de ducto, tanto en material como en diametro y ocasionaria problemas para el tendido de cables de maximqa capacidad.