Effectiveness of a community health worker intervention among African American and Latino adults with type 2 diabetes: a randomized controlled trial

Am J Public Health. 2011 Dec;101(12):2253-60. doi: 10.2105/AJPH.2010.300106. Epub 2011 Jun 16.

Abstract

Objectives: We tested the effectiveness of a culturally tailored, behavioral theory-based community health worker intervention for improving glycemic control.

Methods: We used a randomized, 6-month delayed control group design among 164 African American and Latino adult participants recruited from 2 health systems in Detroit, Michigan. Our study was guided by the principles of community-based participatory research. Hemoglobin A1c (HbA1c) level was the primary outcome measure. Using an empowerment-based approach, community health workers provided participants with diabetes self-management education and regular home visits, and accompanied them to a clinic visit during the 6-month intervention period.

Results: Participants in the intervention group had a mean HbA1c value of 8.6% at baseline, which improved to a value of 7.8% at 6 months, for an adjusted change of -0.8 percentage points (P < .01). There was no change in mean HbA1c among the control group (8.5%). Intervention participants also had significantly greater improvements in self-reported diabetes understanding compared with the control group.

Conclusions: This study contributes to the growing evidence for the effectiveness of community health workers and their role in multidisciplinary teams engaged in culturally appropriate health care delivery.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • African Americans*
  • Community Health Workers*
  • Community-Based Participatory Research
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / ethnology*
  • Diabetes Mellitus, Type 2 / therapy
  • Female
  • Glycated Hemoglobin A / analysis
  • Hispanic Americans*
  • Humans
  • Male
  • Michigan
  • Middle Aged
  • Patient Education as Topic*
  • Poverty
  • Self Care*
  • Urban Population

Substances

  • Glycated Hemoglobin A