Bring the CDE-CHW connection into your practice
Ardis Reed, MPH, RD, LD, CDE
More than 2 million adults — just over 10 individuals per 100 — in Texas have diabetes, according to a 2012 Centers for Disease Control and Prevention report.
“There are many people who need diabetes self-management education (DSME), and there are not enough level 1, 2 and 3 diabetes educators. We need help, and we can utilize community health workers to help us reach more people,” said Ardis Reed, MPH, RD, LD, CDE, adding that Texas has just 1,100 certified diabetes educators, but it also has 3,000 certified community health workers to reach those with and at risk for diabetes. The lack of CDEs in Texas parallels national data.
Reed and Sandra Burke, PhD, APRN, FAADE, FAAN, professor of nursing at the Barnes-Jewish Goldfarb School of Nursing, St. Louis, are co-presenters of “Jazz it Up: Building the CDE-CHWs Connection into Your Practice” which will be presented from 9:15 am to 10:45 am today in Room R02-05.
Participation by newly diagnosed individuals also is a challenge. The average number of years before a person begins participating in DSME after a diabetes diagnosis ranges between seven and 13 years, Reed said. She pointed to a November 2014 Morbidity and Mortality Report, done jointly with AADE and American Diabetes Association, showing that among 95,555 persons with newly diagnosed diabetes, just 6.8 percent of those with third-party insurance and 4 percent with Medicare had participated in DSME within 12 months of the diagnosis.
Sandra Burke, PhD, APRN, FAADE, FAAN
The presenters will help attendees jazz up their practices by providing a better understanding of the new 2014 Diabetes Educator Practice Levels, showing how they can be incorporated into daily work plans, and describing how to integrate community health workers (CHWs) into DSME and support programs to improve participant retention and clinical outcomes.
Texas, where Reed is a diabetes educator with TMF Health Quality Institute in Austin, has a strong community health worker program run by the Texas Department of State Health Services. CHWs go through 160 hours of core competencies and 1,000 hours of practice working with community members before they become certified as CHWs.
Reed will discuss AADE’s new career path program for CHWs, called diabetes educator associate (DEA), levels 1 and 2. Dr. Burke will discuss the diabetes educator levels 1, 2 and 3.
For example, a level 1 DEA could be a lay leader, community health worker, peer counselor, health navigator, health promoter, or coach, and a level 2 DEA could be a certified nursing assistant, medical assistant, diet technician, or pharmacy technician. Reed and Burke will talk about the differing skill levels of associate diabetes educator associates and diabetes educators, how DEAs can provide support, the benefits DEAs can provide to clients and diabetes educators, and how diabetes educators can work with DEAs.
“CHWs are very dedicated, they support the education process, and their strength is working in their communities,” Reed said. “In peer-to peer-education, people are more apt to listen and make behavioral changes than they would with a clinician. The community health worker is able to use more of what I call community talk versus clinical talk. They possess a cultural competence and sensitivity to the neighborhood in which they live.”
She added that for those living in rural areas, a local CHW can guide behavior changes, provide follow-up and make home visits.
“Community health workers like teaching people. They want to help their neighbors. They want to help their elderly. They want to help their communities. That’s their passion,” Reed said.
