Date of Completion
Fall 2026
Document Type
DNP Scholarly Project
Academic Department
School of Nursing
Degree Type
Doctoral
Degree Name
Doctor of Nursing Practice
First Advisor
Jeanine Maine
Second Advisor
Amanda Graham
Abstract
Problem: Haitian Creole–speaking adults with type 2 diabetes receiving care in a federally funded primary care clinic experienced gaps in glycemic control, follow-up attendance, preventive kidney screening, and access to linguistically appropriate diabetes care. The organizational baseline urine albumin-to-creatinine ratio (UACR) screening rate was 41.8%, demonstrating an opportunity to improve preventive diabetes management.
Aim of the Project: The aim was to implement a Chronic Care Model (CCM)-based interdisciplinary intervention over 12 weeks to improve diabetes outcomes, follow-up care, and UACR screening among Haitian Creole–speaking adults with type 2 diabetes.
Review of the Evidence: Current evidence supports structured chronic disease management, interdisciplinary collaboration, culturally and linguistically appropriate education, and systematic follow-up to improve diabetes self-management, glycemic outcomes, and preventive care.
Project Design: This quality improvement project used the Model for Improvement and Plan-Do-Study-Act (PDSA) cycles to evaluate changes in care delivery. The OhioHealth Change Management Model supported stakeholder engagement, readiness, adoption, and sustainability planning.
Intervention: The intervention incorporated structured follow-up, telephone reminders 24–48 hours before appointments, Haitian Creole interpretation through Propio, interdisciplinary collaboration, and referrals to clinical pharmacy, dietetics, and social services based on patient needs.
Significant Findings/Outcomes: Forty-one patients were evaluated. Among 13 patients with paired elevated HbA1c measurements, mean HbA1c decreased from 10.13% to 9.19%, an absolute reduction of 0.94 percentage points; all 13 demonstrated improvement. UACR screening increased from a 41.8% organizational baseline to 51.2%, a 9.4-percentage-point increase. Of 56 potential encounters, 41 were completed and 15 were missed, resulting in a 73.2% attendance rate.
Implications for Nursing: Findings support advanced practice nursing leadership in interdisciplinary diabetes management, language-access services, preventive screening, and structured follow-up. Sustaining these processes may strengthen equitable chronic disease management while continued monitoring of HbA1c, UACR screening, and appointment adherence identifies opportunities for further improvement.
Recommended Citation
Russell, Tammy W., "Lowering A1c in Haitian Creole Adults with Type 2 Diabetes" (2026). All Doctor of Nursing Practice (DNP) Scholarly Projects. 77.
https://fuse.franklin.edu/dnp-project/77
Rights
Copyright, all rights reserved
