Health Extension for Diabetes: Development, Implementation, and Effectiveness of a Community-Based Diabetes...

Area of Science:

• Public Health
• Community Health
• Diabetes Management

Background:

• Community-based programs are crucial for managing chronic diseases like diabetes.
• The Health Extension for Diabetes (HED) program utilizes trained rural agents for diabetes self-management support.
• Evaluating HED through the RE-AIM framework provides insights into its real-world application.

Purpose of the Study:

• To evaluate the Health Extension for Diabetes (HED) program using the RE-AIM framework.
• To assess the program's Reach, Effectiveness, Adoption, Implementation, and Maintenance.
• To determine the program's impact on diabetes self-management and health outcomes.

Main Methods:

• Longitudinal evaluation of 1526 participants from 2018-2024.
• Pre- and postsurveys measured knowledge, self-efficacy, and health behaviors at baseline, 1 year, and 2 years.
• Paired-sample t-tests analyzed significant changes in outcomes.

Main Results:

• 94% graduation rate indicates high program engagement.
• Significant improvements observed in quality of life, diet, exercise, glucose testing, and foot care.
• Increases in diabetes knowledge and self-efficacy, alongside reductions in weight, BMI, and HbA1c.

Conclusions:

• The HED program demonstrates a scalable and sustainable model for community-based diabetes self-management.
• Key implementation strategies identified through RE-AIM evaluation can guide future program expansion.
• HED effectively supports rural populations in managing their diabetes.