Cultural-Based Diabetes Self-Care Management Education for People with Type 2 Diabetes Mellitus: Empowering Community Health Workers (Kaders) Program Evaluation

https://doi.org/10.20956/icon.v8i1.26055

Authors

Keywords:

Community health workers, Kader, Community health centers, Puskesmas, People with T2DM

Abstract

Aim: The aim of this study was to understand the perspectives of Kaders, community health nurses (CHNs), and the community on an empowerment program for Kaders in Indonesia. The program aimed to help Kaders provide cultural-based diabetes self-care management education for people with type 2 diabetes mellitus (T2DM). Methods: The empowerment program consisted of a four-month training program, including two full-day sessions on cultural-based health education for people with T2DM, followed by four months of monitoring T2DM patients. Fifteen Kaders from community health centers in Makassar City participated in the program. Focus group discussions (FGDs) were conducted with Kaders to explore their perceptions and experiences related to the program. Interviews were also conducted with CHNs and people with T2DM regarding their perceptions of the program. Results: The FGDs with Kaders resulted in four themes: overall training, guideline book, education and monitoring program, and potential obstacles. CHNs highlighted the benefits of the program, the guideline book, and the impact on patients. Patients identified three themes, including the benefits of the program, what was taught, and what was improved. Conclusion: The empowerment program for Kaders in Indonesia has proven to be beneficial for Kaders, CHNs, and the community. Kaders have the potential to provide effective and efficient health education with proper preparation and empowerment through knowledge and skills.

Downloads

Download data is not yet available.

Author Biographies

Andi Saputri Mulyana, Nursing Department, Faculty of Health Sciences, Universitas Patria Artha, Makassar, Indonesia

Lecturer

Indargairi Indargairi, Nursing Department, Faculty of Health Sciences, Universitas Mega Rezky, Makassar, Indonesia

Lecturer

Rohan Dexter Jeremiah, Department of Human Development and Nursing Science, University of Illinois Chicago, Chicago, USA

Interim Associate Dean for Global Health; Associate Professor, 
Dimensions

Adair, R., Christianson, J., Wholey, D. R., White, K., Town, R., Lee, S., . . . Elumba, D. (2012). Care guides: employing nonclinical laypersons to help primary care teams manage chronic disease. J Ambul Care Manage, 35(1), 27-37. https://doi.org/10.1097/JAC.0b013e31823b0fbe

Balcazar, H., Rosenthal, E. L., Brownstein, J. N., Rush, C. H., Matos, S., & Hernandez, L. (2011). Community health workers can be a public health force for change in the United States: three actions for a new paradigm. American Journal of Public Health, 101(12), 2199-2203. https://doi.org/10.2105/AJPH.2011.300386

Brooks, B. A., Davis, S., Frank-Lightfoot, L., Kulbok, P. A., Poree, S., & Sgarlata, L. (2018). Building a community health worker program: The key to better care, better outcomes, & lower costs https://www.aha.org/system/files/2018-10/chw-program-manual-2018-toolkit-final.pdf

Brunk, D. R., Taylor, A. G., Clark, M. L., Williams, I. C., & Cox, D. J. (2017). A Culturally Appropriate Self-Management Program for Hispanic Adults With Type 2 Diabetes and Low Health Literacy Skills. J Transcult Nurs, 28(2), 187-194. https://doi.org/10.1177/1043659615613418

Burns, M. E., Galbraith, A. A., Ross-Degnan, D., & Balaban, R. B. (2014). Feasibility and evaluation of a pilot community health worker intervention to reduce hospital readmissions. International Journal for Quality in Health Care 26(4), 358-365. https://doi.org/10.1093/intqhc/mzu046

Collinsworth, A., Vulimiri, M., Snead, C., & Walton, J. (2014). Community health workers in primary care practice: redesigning health care delivery systems to extend and improve diabetes care in underserved populations. Health Promot Pract, 15(2 Suppl), 51s-61s. https://doi.org/10.1177/1524839914539961

Collinsworth, A. W., Vulimiri, M., Schmidt, K. L., & Snead, C. A. (2013). Effectiveness of a community health worker-led diabetes self-management education program and implications for CHW involvement in care coordination strategies. Diabetes Educ, 39(6), 792-799. https://doi.org/10.1177/0145721713504470

Hadziabdic, E., Pettersson, S., Marklund, H., & Hjelm, K. (2020). Development of a group-based diabetes education model for migrants with type 2 diabetes, living in Sweden [Research Support, Non-U.S. Gov't]. Primary Health Care Research & Development, 21, e50. https://doi.org/https://dx.doi.org/10.1017/S1463423620000493

Hartzler, A. L., Tuzzio, L., Hsu, C., & Wagner, E. H. (2018). Roles and functions of community health workers in primary care. Annals of Family Medicine, 16(3), 240-245. https://doi.org/10.1370/afm.2208

Hennink, M. M. (2014). Focus group discussions. Oxford University Press.

Hennink, M. M., Kaiser, B. N., & Weber, M. B. (2019). What Influences Saturation? Estimating Sample Sizes in Focus Group Research. Qual Health Res, 29(10), 1483-1496. https://doi.org/10.1177/1049732318821692

Heshmati, H., Shakibazadeh, E., Foroushani, A., & Sadeghi, R. (2020). A comprehensive model of health education barriers of health-care system in Iran [Original Article]. Journal of Education and Health Promotion, 9(1), 106-106. https://doi.org/10.4103/jehp.jehp_23_20

Jauhar, M., Rohana, I. G. A. P. D., Rachmawati, U., Kusumawardani, L. H., & Rasdiyanah, R. (2019). Empowering community health volunteer on community-based tuberculosis case management programs in lower-income countries: A systematic review. Journal of Community Empowerment for Health, 2(2), 172-180. https://doi.org/10.22146/jcoemph.47148

Kadar, K. S., McKenna, L., & Francis, K. (2014). Scoping the context of programs and services for maintaining wellness of older people in rural areas of Indonesia. International Nursing Review, 61(3), 310-317. https://doi.org/10.1111/inr.12105

Kivelä, K., Elo, S., Kyngäs, H., & Kääriäinen, M. (2014). The effects of health coaching on adult patients with chronic diseases: A systematic review. Patient Education and Counseling, 97(2), 147-157. https://doi.org/https://doi.org/10.1016/j.pec.2014.07.026

Lehmann, U., & Sanders, D. (2007). Community health workers: What do we know about them? The state of the evidence on programmes, activities, costs and impact on health outcomes of using community health workers https://www.who.int/hrh/documents/community_health_workers.pdf

Leimena, S. L. (1989). Posyandu: a community based vehicle to improve child survival and development. Asia Pac J Public Health, 3(4), 264-267. https://doi.org/10.1177/101053958900300402

Lewin, S., Munabi-Babigumira, S., Glenton, C., Daniels, K., Bosch-Capblanch, X., van Wyk, B. E., . . . Scheel, I. B. (2010). Lay health workers in primary and community health care for maternal and child health and the management of infectious diseases. The Cochrane Database of Systematic Reviews, 2010(3), CD004015-CD004015. https://doi.org/10.1002/14651858.CD004015.pub3

Metzler, K., & Scott, W. (2013). The SAGE Handbook of Qualitative Data Analysis (1st ed.). SAGE Publications.

Ministry of Health Indonesia. (2011). Pedoman umum pengelolaan Posyandu (Posyandu general guide). Kemenkes RI/Kelompok Kerja Operasional (POKJANAL POSYANDU). https://promkes.kemkes.go.id/pedoman-umum-pengelolaan-posyandu

Moffett, M. L., Kaufman, A., & Bazemore, A. (2018). Community health workers bring cost savings to patient-centered Medical Homes. Journal of community health, 43(1), 1-3. https://doi.org/10.1007/s10900-017-0403-y

National Institute of Health. (2014). Role of community health workers. National Heart, Lung, and Blood Institute, Department of Health & Human Services U.S. https://www.nhlbi.nih.gov/health/educational/healthdisp/role-of-community-health-workers.htm

Onwuegbuzie, A. J., Dickinson, W. B., Leech, N. L., & Zoran, A. G. (2009). A Qualitative Framework for Collecting and Analyzing Data in Focus Group Research. International Journal of Qualitative Methods, 8(3), 1-21. https://doi.org/10.1177/160940690900800301

Pérez-Escamilla, R., Damio, G., Chhabra, J., Fernandez, M. L., Segura-Pérez, S., Vega-López, S., . . . D'Agostino, D. (2015). Impact of a community health workers-led structured program on blood glucose control among latinos with type 2 diabetes: the DIALBEST trial. Diabetes Care, 38(2), 197-205. https://doi.org/10.2337/dc14-0327

Perry, H., Zulliger, R., Scott, K., Javadi, D., Gergen, J., Shelley, K., . . . Strodel, R. (2017). Case studies of large-scale community health worker programs: Examples from Afghanistan, Bangladesh, Brazil, Ethiopia, Niger, India, Indonesia, Iran, Nepal, Pakistan, Rwanda, Zambia, and Zimbabwe. USAID/MCHIP. https://www.mcsprogram.org/wp-content/uploads/2017/01/CHW-CaseStudies-Globes.pdf

Perry, H. B. (2020). Health for the people: National community health worker programs from Afghanistan to Zimbabwe. USAID/MSCP. https://www.humanitarianlibrary.org/sites/default/files/2021/07/PA00WKKN.pdf

Perry, H. B., Zulliger, R., & Rogers, M. M. (2014). Community health workers in low-, middle-, and high-income countries: an overview of their history, recent evolution, and current effectiveness. Annu Rev Public Health, 35, 399-421. https://doi.org/10.1146/annurev-publhealth-032013-182354

Perveen, S., Lassi, Z. S., Mahmood, M. A., Perry, H. B., & Laurence, C. (2022). Application of primary healthcare principles in national community health worker programmes in low-income and middle-income countries: a scoping review. BMJ Open, 12(2), e051940. https://doi.org/10.1136/bmjopen-2021-051940

Rahmawati, R., & Bajorek, B. A. (2015). Community health worker–based program for elderly people with hypertension in Indonesia: A qualitative study. Prev Chronic Dis, 12(E175), 1-9. https://doi.org/10.5888/pcd12.140530.

Rohmani, N., & Utari, D. (2021). The role of leadership and its relationship with the performance of community health volunteer: A survey in rural Indonesia. Disease Prevention and Public Health Journal, 15(2), 103-109. https://doi.org/10.12928/dpphj.v15i2.4194

Scott, K., Beckham, S. W., Gross, M., Pariyo, G., Rao, K. D., Cometto, G., & Perry, H. B. (2018). What do we know about community-based health worker programs? A systematic review of existing reviews on community health workers. Human Resources for Health, 16(1), 39. https://doi.org/10.1186/s12960-018-0304-x

Setiawan, A., & Christiani, Y. (2018). Integrated health post for child health Pposyandu) as a community-based program in Indonesia: An exploratory study. Jurnal Keperawatan Indonesia 21(3), 150-158. https://doi.org/10.7454/jki.v21i3.600

Sinclair, K. A., Zamora-Kapoor, A., Townsend-Ing, C., McElfish, P. A., & Kaholokula, J. K. (2020). Implementation outcomes of a culturally adapted diabetes self-management education intervention for Native Hawaiians and Pacific islanders. BMC Public Health, 20(1), 1-11. https://doi.org/10.1186/s12889-020-09690-6

Speziale, H. S., & Carpenter, D. R. (2011). Qualitative research in nursing : advancing the humanistic imperative (5th ed.). Wolters Kluwer Health/Lippincott Williams & Wilkins.

Viswanathan, M., Kraschnewski, J. L., Nishikawa, B., Morgan, L. C., Honeycutt, A. A., Thieda, P., . . . Jonas, D. E. (2010). Outcomes and costs of community health worker interventions: a systematic review. Med Care, 48(9), 792-808. https://doi.org/10.1097/MLR.0b013e3181e35b51

Waitzkin, H., Getrich, C., Heying, S., Rodríguez, L., Parmar, A., Willging, C., . . . Santos, R. (2011). Promotoras as mental health practitioners in primary care: a multi-method study of an intervention to address contextual sources of depression. Journal of community health, 36(2), 316-331. https://doi.org/10.1007/s10900-010-9313-y

Zuraida, E., Irwan, A. M., & Sjattar, E. L. (2021). Self-Care Management Education Through Health Coaching for Heart Failure Patients. The Journal for Nurse Practitioners. https://doi.org/https://doi.org/10.1016/j.nurpra.2021.09.017

Published

2023-08-26

How to Cite

Kadar, K. S., Mulyana, A. S., Indargairi, I., & Jeremiah, R. D. (2023). Cultural-Based Diabetes Self-Care Management Education for People with Type 2 Diabetes Mellitus: Empowering Community Health Workers (Kaders) Program Evaluation. Indonesian Contemporary Nursing Journal (ICON Journal), 8(1), 16-28. https://doi.org/10.20956/icon.v8i1.26055

Issue

Vol. 8 No. 1 (2023): Volume 8 No. 1 Agustus 2023

Section

ORIGINAL ARTICLE
Copyright & Licensing
Authors who publish with this journal agree to the following terms:

Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.

Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.

Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).