From the 2022 HVPA National Conference

Dave Young, (Undergraduate, Lahai Health, University of Washington), Anna Pounds (Undergraduate), Candy Mcdonalds (Undergraduate), Bill Young (Undergraduate)


Low-income and underinsured adults cannot utilize most diabetes management and education programs because they require medical insurance. An accessible, robust intervention is needed to address the growing disparity in patient education. In 2021, Lahai Health, a free clinic, developed and implemented a 12-month program to help patients develop healthy habits to live with diabetes or hypertension and maintain personal health.


The aim of this study was to evaluate the impacts of an interventional diabetes and hypertension education program for patients at a free clinic.


A total of 260 non-unique participants were recruited for diabetes and/or hypertension programs, and the inclusion criteria was a diagnosis of either: Type 1 or 2 diabetes, being “pre-diabetic”, or hypertension. All patients were living under the 300% Federal Poverty Level and either had no insurance or were underinsured.
The program included patient education (in multiple languages), which took place at the clinic through videos, consultations with a dietician, and interviews with the nurse and health care provider. Lahai implemented resources and tools available through the Association of Diabetes Care and Education Specialists (ADCES), specifically the ADCES7 Self-Care Behaviors.

At six and twelve months, participants were followed-up on HbA1c levels and blood pressure. The results were then sent to Lahai providers using a specific criterion to determine whether patients had improved their condition.


Lahai providers found that 28.9% of patients with diabetes or prediabetes improved their condition, and 44.7% of patients with hypertension improved their condition.


There is an urgent need for diabetes education programs for underserved communities. This poster describes the methodology and design of the program and how to apply it to other clinics.

What are academic medical centers across the country doing to improve healthcare value?

Value improvement guides: Published reviews in JAMA Internal Medicine coauthored by experienced faculty from multiple leading medical centers, with safety outcomes data and an implementation blue print.

Review article detailing 25 labs to refine for high value quality improvement | July 2020

MAVEN campaign: Free 4 year high value care curriculum online.

Join the Alliance! Membership is free with institutional approval and commitment to improving value in your medical center.

Learn more about HVPA on Health Affairs Blog