Mexican American Trial of Community Health Workers: A Randomized Controlled Trial of a Community Health Worker Intervention for Mexican Americans With Type 2 Diabetes Mellitus

Am J Public Health. 2014 Aug;104(8):1540-8. doi: 10.2105/AJPH.2013.301439. Epub 2013 Aug 15.

Abstract

Objectives: We assessed whether community health workers (CHWs) could improve glycemic control among Mexican Americans with diabetes.

Methods: We recruited 144 Mexican Americans with type 2 diabetes between January 2006 and September 2008 into the single-blinded, randomized controlled Mexican American Trial of Community Health Workers (MATCH) and followed them for 2 years. Participants were assigned to either a CHW intervention, delivering self-management training through 36 home visits over 2 years, or a bilingual control newsletter delivering the same information on the same schedule.

Results: Intervention participants showed significantly lower hemoglobin A1c levels than control participants at both year 1 Δ = -0.55; P = .021) and year 2 (Δ = -0.69; P = .005). We observed no effect on blood pressure control, glucose self-monitoring, or adherence to medications or diet. Intervention participants increased physical activity from a mean of 1.63 days per week at baseline to 2.64 days per week after 2 years.

Conclusions: A self-management intervention delivered by CHWs resulted in sustained improvements in glycemic control over 2 years among Mexican Americans with diabetes. MATCH adds to the growing body of evidence supporting the use of CHWs to reduce diabetes-related health disparities.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Blood Pressure
  • Community Health Services / methods
  • Community Health Workers*
  • Diabetes Mellitus, Type 2 / ethnology
  • Diabetes Mellitus, Type 2 / therapy*
  • Female
  • Glycated Hemoglobin A / analysis
  • Humans
  • Male
  • Mexican Americans*
  • Middle Aged
  • Patient Compliance / ethnology
  • Patient Compliance / statistics & numerical data
  • Self Care / methods
  • Single-Blind Method

Substances

  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human