Carol Howe, Texas Christian University – Empowering Hispanic Agricultural Workers with Diabetes Education

On Texas Christian University Week:  How do we empower Hispanic agricultural workers to get the health care they need?

Carol Howe, Paula R. and Ronald C. Parker Endowed professor of Nursing and Director of Nursing Research & Scholarship, delves into this.

Carol Howe, Ph.D., is the Paula R. and Ronald C. Parker Endowed Professor of Nursing at Texas Christian University (TCU). She is a registered nurse, diabetes care and education specialist, and is on the National Advocacy Committee where she serves as the Texas Advocacy Lead for the Association of Diabetes Care and Education Specialists, advocating for increased access to care. She has received honors, including the Leadership Award from the American Diabetes Association, the Excellence in Education Award from the Pediatric Endocrinology Nursing Society, the Penn Nursing Alumni Award for Clinical Excellence, and is a Fellow of the American Academy of Nursing.

Empowering Hispanic Agricultural Workers with Diabetes Education

Hispanics have the highest rate of diabetes compared to non-Hispanic Blacks, Asians and Whites. Hispanic agricultural workers face systemic health barriers, economic challenges and lack of follow-up care, which complicate diabetes self-management.

Most agricultural workers in the U.S. are of Mexican descent. Nearly 40% of agricultural workers are unaware of their diabetes and often have limited access to health care services. Barriers include cost, language challenges, lack of health insurance, migratory lifestyles and fear of law and immigration enforcement. 

In collaboration with Dr. Anabel Rodriguez from the School of Public Health at Texas A&M, Dr. Teresa Wagner from the School of Public Health at the University of North Texas and Luz Chavez as the local coordinator, she conducted a longitudinal study aimed to assess the effectiveness of community coaches in reducing A1C levels and enhancing diabetes knowledge among diabetic agricultural workers in the Texas Panhandle.

The pilot project consisted of two phases to create, deliver and evaluate a community diabetes coaching program.

In Phase One, community coaches were trained on a low literacy, Spanish language diabetes education program, which they in Phase Two, delivered to Spanish-speaking agricultural workers in the Texas panhandle region over twelve weeks.

Workers’ diabetes knowledge improved significantly from baseline, indicating a large learning effect.

Diabetes control, measured by hemoglobin A1C, decreased from 8.3% at baseline to 7.6% after the coaching program, representing a 0.7% decrease. Changes in A1C greater than 0.5% in response to intervention is considered clinically significant.

The findings from this study demonstrate that culturally and linguistically tailored community coaching programs can significantly improve diabetes knowledge and control among Hispanic agricultural workers, underscoring the importance of literacy appropriate, feasible and sustainable health interventions for this vulnerable population.  

Read More:
[National Library of Medicine] – Effectiveness of Trained Community Lay Workers on Glycemic Control, Knowledge, and Self-Efficacy Among Agricultural Workers with Diabetes in the Texas Panhandle