The Campesinos Diabetes Management Program (CDMP) is offered by Campesinos Sin Fronteras (CSF). The program assists medically underserved and poor migrant and seasonal farm workers and new immigrants who have diabetes and who live in the rural border communities of Somerton, Gadsden, San Luis, Wellton, Dateland, and “colonias” surrounding the City of Yuma in Yuma County, AZ.

The goal of CDMP is to build strong collaborations among medical providers and community resources to advance the care and self management of type 2 diabetes among the targeted population. CDMP has been instrumental in developing and providing community resources and self management education and support services for this population by creating strong partnerships among CSF, Sunset Community Health Center, the University of Arizona Cooperative Extension and the Arizona College of Public Health. The program has been effective because of the intimate knowledge that CSF staff have of the target population, which led to the main strength of the project: direct involvement in the target population through recruiting and hiring Promotoras de Salud, or community health workers.

The promotoras have proven to be a credible and effective resource of health information and advocacy for their community. Their primary purpose is to provide advocacy, support and education for people with diabetes and help them manage their condition. Promotoras recruit new participants for the program throughout the community in schools, churches, faith based organizations, stores, neighborhood events and health fairs.

Promotoras check on participants at least once a week, either at groups, in the person’s home, or by phone. They remind participants to attend their weekly support groups and/or cooking classes. They inform them about community resources and refer them to other services they may need. Promotoras also help participants order supplies for their glucometers and translate letters they receive from their medical providers or insurers. They call and visit participants who are sick or in the hospital and celebrate their birthdays too.

To aid the promotoras, CDMP has implemented the “Animadora” model through which long-term program participants can be trained to help promotoras conduct the support groups. But most important are the “little things” promotoras give to participants like attention, care, kindness, compassion, understanding, confidentiality and respect.

Staff Person Praised -- Emma Torres of Campesinos Sin Fronteras is highlighted as one of the 10 most influential Hispanics in Yuma County.

Summary

Key Interventions

• Promotora outreach to the farm worker community offering:
• Animadora-led support groups
• Case management and client follow up
• Home visits/family education (see curriculum)
• Diabetes education classes
• Community workshops and forums
• Collaboration with an extensive network of community agencies

Key Accomplishments

• Significantly strengthened the partnership with Sunset Clinic, achieving reciprocal referrals, program space and shared staff
• Developed a family curriculum for diabetes education in the home
• Promotoras developed an 11module curriculum that addresses diabetes follow up and support, coping skills and the importance of mental health

Lessons Learned

• Promotoras play an important role in helping people with their diabetes self management at home and in the community
• Community promotoras help people with diabetes manage their negative emotions
• Promotora-led support groups help people with diabetes improve self management skill

Grantee Presentations

• Building Community Support for Diabetes Care in Migrant and Seasonal Farmworker Communities in Yuma County, Arizona (10/2006)
• Promoting Healthy Coping Skills in Migrant Farmworker Communities (8/2006)
• A Collaborative Between Campesinos Sin Fronteras, Sunset Community Health Center, University of Arizona College of Public Health and Yuma County Cooperative Extension (3/2004)