Improving Diabetes Prevention and Management

Grantee Name

Charles B. Wang Community Health Center

Funding Area

Improving Diabetes Prevention and Management

Publication Date

January 2012

Grant Amount


Grant Date:

January 1, 2008–December 31, 2009


Diabetes is a growing epidemic. In New York, the prevalence rate is higher in Asian communities, particularly among adults born in South Asia.

With proper management, diabetes can be controlled; however, medically underserved and disadvantaged groups, such as Asian Americans, often have difficulty managing the disease.

In January 2008, NYHealth awarded Charles B. Wang Community Health Center (CBW) a grant to form the Chinatown Diabetes Accelerating Collaboration to Improve Health Outcomes Now (ACTION) initiative to further improve care for patients with diabetes. This initiative allowed CBW to build a foundation for continued sustainability of diabetes management activities. NYHealth funded this project through its 2007 Setting the Standard: Advancing Best Practices in Diabetes Management request for proposals.

Outcomes and Lessons Learned

  • Improved workflow, increased productivity, and enhanced communication between patients and the care manager through advanced use of its EMR and addressing quality improvement with a systemwide approach;
  • Created a diabetes registry, a diabetes management flowsheet, and certified diabetes educator encounter forms within the EMR for continuous tracking of patients in need of diabetes services;
  • Hosted focus groups to understand and better address the impact of Chinese culture on diabetes care and self-management;
  • Established a diabetes education and self-care skills support group using a curriculum based on the ADA guidelines for diabetes care;
  • Received ADA certification so that visits to a certified diabetes educator are now billable events; and
  • Achieved National Committee for Quality Assurance patient-centered medical home certification, which enhanced its Medicaid Managed Care rates.

Read the report associated with this grant, “Setting the Standard: A Foundation Initiative to Achieve Best Practices in Diabetes Management.”