Submitted to the School of Nursing and Health Professions of Colorado Christian University Lakewood, Colorado in partial fulfillment of the requirements for the degree of DOCTOR OF NURSING PRACTICE Abstract Background: There is a high incidence of diabetes within the multi-ethnic migrant population. Yet, this population faces many barriers related to language, culture, and income level when accessing the healthcare system. As a result, interventions to improve glycemic control must be targeted and include a culturally competent approach. Purpose: The purpose of this project was to assess how a 3-month long culturally competent telehealth intervention, focused on mutual goal-setting and frequent patient interactions to encourage self-monitoring adherence, would impact hemoglobin A1c levels (HbA1c) in medically underserved multi-ethnic migrant patients. Methods: This project included a randomized design, with a total of 42 participants. For the intervention, the telehealth manager set mutual goals and interacted with participants every other week through individual telehealth sessions. Patients self-measured blood glucose levels using a Bluetooth glucometer that transmitted data through the central telehealth system. Results: A significant reduction in HbA1c levels occurred between the control and intervention group for individuals with a baseline HbA1c level of 9.0% or higher. Although there was a significant improvement in HbA1c levels from baseline to endpoint in participants with a baseline HbA1c level of 7.0% or higher, no statistical significance was observed between groups. Frequency of blood glucose monitoring played an important role in this project, evident by a strong correlation between the number of times blood glucose levels were self-measured by patients and the reduction they achieved in HbA1c levels between baseline and endpoint. Keywords: diabetes, telehealth, telemedicine, glycemic control, hemoglobin A1c, medically underserved, multi-ethnic, culturally diverse, migrants