The Success of the Everyone with Diabetes Counts (EDC) program is largely due to the innovative approaches used to support its goals, including:

Outreach and Partnerships

Examples of QIN-QIO partnerships and outreach activities include:

  • Outreach and partnership building.
  • Developing solutions to address cultural challenge, literacy issues, and limited health care access.
  • Building capacity and creating a sustainable infrastructure. 
    • Working with Area Agencies on Aging (AAAs) and senior centers who request classes on chronic disease management in addition to Diabetes Self-Management Education (DSME)
    • Partnering with the Centers for Disease Control and Prevention (CDC) 1305 state grantees.
    • Connecting with local supermarket chains to offer DSME, educate pharmacist, and provide education materials.
    • Forming relationships with universities and professional and organizational agencies. 
      • E.g., working with state ophthalmology societies to mitigate the challenges in communicating eye exam results to primary care physician offices.
    • Partnerships with faith-based organizations 
      • E.g., many churches host DSME classes free of charge, and many pastors support, endorse and host DSME classes.
    • Outreach through special campaigns, publicity, and partnerships. 
      • E.g., a QIN-QIO partnered with a gospel recording artist to perform a series of 30-second radio spots centering on the importance of diabetes management through diet and exercise.

Developing Solutions to Address Cultural Challenges, Literacy Issues, and Limited Health Care Access

EDC focuses on disparities in diabetes care for minority underserved and rural populations. Below are several examples of EDC to address challenges impacting these groups.


  • A QIN-QIO launched an aggressive marketing campaign through Spanish-language radio and social media to recruit the Hispanic population, many of whom rely on the Spanish-language media outlets for health information
  • In cases where DSME participants are non-English speaking, interpreters are used in the classroom. Spanish-speaking trainers also lead classes in Spanish.
  • DSME class materials have been translated into braille for participants who are visually impaired.

Culture & Access

  • Lack of trust by the target populations in certain regions has made it difficult to recruit participants. In these hard-to-reach communities, educators residing in those communities have been recruited to teach the DSME classes in their homes and at faith-based organization. This also promotes cultural competency. This grassroots approach has shown success in alleviating communities' unease and distrust, increasing participation in DSME classes.
  • DSME addresses two frequently cited barriers to healthcare access: patients' knowledge about specific chronic conditions and cost (the class is no cost to participants).


  • DSME classes are taught for low-literacy populations. Resources have been developed using pictures and images to portray information, instead of using text-heavy materials that can be challenging for participants with low literacy.

Building Capacity and Sustainability

QIN-QIOs nationwide are working to promote and facilitate the continued training of diabetes educators and the continuation of DSME and Diabetes Self-Management Training (DSMT). They will accomplish this using the following training structure:

  • Train-the-trainer programs: 
    • Building a network of DSME educators in communities is critical to promoting public health.
    • Offering Certified Diabetes Educator (CDE) exam prep classes supports those interested in taking the CDE exam.
  • Community health worker training: 
    • Community health workers (CHW) enhance the cultural competency of DSME provided through EDC. Training CHWs is important because these individuals are trusted by communities for their knowledge and expertise.
  • Assisting health care providers and organizations to develop AADE-accredited or ADA-recognized diabetes education programs: 
    • Partnerships are forming with HRSA-funded Federally Qualified Health Centers (FQHC), pharmacies, clinics, community-based hospitals, and with accountable care organizations (ACO) to develop AADE-accredited or ADA-recognized Diabetes Education programs. Completing one of these two processes allows programs to bill for the Medicare diabetes self-management training (DSMT) benefit.
  • Physical and geographic accessibility for trainers: 
    • Distance learning to train educators and interactive audio-visual equipment for train-the-trainer classes will allow more CHWs and and lay diabetes educators to take part in and complete their respective programs.