We attempted to develop a culturally sensitive alternative approach to
diabetes management in a multiethnic, socially disadvantaged communit
y (Waianae, Hawaii). The aims of this 3.5-year demonstration project w
ere to establish regular community-based medical contact with diabetic
patients who had a history of nonadherence to treatment regimens and
to determine whether this strategy would lead to better health care (p
articularly improved self-management) in these patients. This communit
y-based, culturally sensitive outreach system of medical follow up dra
matically improved the amount and quality of medical care provided to
this high-risk subpopulation of patients with diabetes.