"On The Road"
Joslin Diabetes Center in Boston works with the Cooperative State Research, Education and Extension Service (CSREES), a branch of the USDA, that has a long experience working with clients in underserved areas, particularly in areas of nutrition. These two groups have developed a diabetes program outside of the usual medical care system that can be delivered by leaders without a diabetes background to underserved patients.
The "On the Road to Living Well with Diabetes" Program, which is delivered to small groups, includes on-site testing of blood pressure, portable device A1c measurements, and sometimes microalbumin and cholesterol. The Program includes a series of colorful low-literacy flip charts and a 20-page booklet that describes in easy-to-understand terms five tests that all people with diabetes should have, why these tests are important, and what the results mean in terms of people’s overall diabetes care.
In a controlled trial in Hawaii, the Program was shown to be effective in improving patient knowledge, healthcare beliefs, and increasing patient utilization of local medical resources. In addition, improvements in A1c have also been documented in those participating in the Program. After development and validation of the Program, training methods and materials (English, Spanish, Russian, Chinese) were developed have been implemented in various clinics participating in ongoing Diabetes Collaboratives, Native American groups, Department of Public Health programs, grassroots community organizations, rural health clinics, parish nurses and individual diabetes educators and physicians in underserved areas. Several different evaluation tools were also developed to meet the constraints of the differing locations. To date, the Program is being used in 64 different sites, with over 4,000 patients participating. It has been delivered by a variety of individuals in a number of different formats.
The Program is ideal for outreach programs, but has also been used in clinic settings as the initial session in a diabetes education series. It can be delivered by local community workers as well as experienced diabetes educators. A one-day training session provides the necessary background on delivery and use of the testing devices.
Materials can be purchased at the Joslin Store.
For additional information on setting up a Program please contact
Richard Jackson, M.D. at
Amy Larson at
Page last updated: October 31, 2014