Improving Referral Rates of Hispanics with Type 2 Diabetes Mellitus to the IDEAS Program

Background: The incidence and prevalence of type 2 diabetes mellitus (T2DM) among Hispanics in the U.S. are higher than the national average. The risk for diabetes and issues with glycemic management result from disparities in social determinants of health within the Hispanic population. Low incomes, sparse resources, and decreased opportunities to receive education on diabetes management are sociocultural factors that also contribute to issues with glycemic management among Hispanic patients. The significant prevalence of T2DM among the burgeoning population underscores the importance of managing this chronic disease and emphasizes the need for improvements in patient education. Methods: The methods used for this project included five steps. First, a needs assessment was done on the need for referrals to the Intensive Diabetes Education and Support (IDEAS) program. Second, an intervention was developed that consisted an educational PowerPoint for providers about the IDEAS program, an intake form for referral to IDEAS program, an IDEAS handout in English and Spanish for patients, and a clinical algorithm for providers and staff to screen Hispanic patients with T2DM. Third, the intervention was implemented. Fourth, referrals made and attendance of Hispanics with T2DM at the IDEAS program were evaluated and compared to data before the outreach intervention. Fifth, health team support for the self- management of Hispanics with T2DM was assessed. Quantitative data was collected on the number of referrals and attendance of Hispanic patients with T2DM at the IDEAS program. Descriptive statistics were used to report team support for referring Hispanic patients with T2DM to the IDEAS program. Results: Providers demonstrated improved knowledge and confidence in making referrals to the IDEAS program following the educational PowerPoint presentation. Provider satisfaction with the PowerPoint presentation was rated as excellent/very good, and all participating providers supported feasibility of the PowerPoint presentation to be recommended to other clinical providers. Incorporating the referral process in the Electronic Health Record system demonstrates the ease of sustainability of the referral process to the IDEAS program. The ability to raise awareness of the IDEAS program for Hispanic patients with T2DM supports the implementation of this outreach intervention in other clinical settings. Conclusion: The purpose of this project was to share information about the IDEAS program among Hispanics with T2DM to increase referrals and attendance at the Utah Diabetes and Endocrinology Center to facilitate self-management among Hispanic patients with T2DM. The next steps would be barriers for providers referring Hispanic patients with T2DM to the IDEAS program and patients attending the IDEAS program, and modifying the outreach intervention to address the existing barriers. Following this, the goal would be to increase the number of providers who refer Hispanics with T2DM to the IDEAS program by including other clinics and enhancement of the IDEAS program among Hispanic patients and care partners. Next steps would also include examining if increased attendance in the IDEAS program leads to a decrease in HbA1C levels for Hispanic patients with T2DM, especially those in the clinic whose levels were greater than nine percent.