Effectiveness of a community health worker-led diabetes self-management education program and implications for CHW involvement in care coordination strategies

Diabetes Educ. Nov-Dec 2013;39(6):792-9. doi: 10.1177/0145721713504470. Epub 2013 Sep 19.

Abstract

Purpose: The purpose of this study was to evaluate the effectiveness of a Community Health Worker (CHW)-led diabetes self-management education (DSME) program and to understand how CHWs and primary care providers (PCPs) work together to provide comprehensive diabetes care.

Methods: A quantitative pre- and postassessment of change in patients' blood glucose levels (A1C), blood pressure, and body mass index was performed to determine the clinical effectiveness of the program. Qualitative, semi-structured interviews with 5 CHWs and 7 PCPs were conducted to assess how CHWs were incorporated into clinical teams and their impact on care delivery and diabetes-related outcomes.

Results: Patients who participated in the program experienced a statistically significant decrease in mean A1C levels and systolic blood pressure readings 1 year post baseline. CHWs provided high-quality care and bridged the gap between patients and care providers through diabetes management support and education, medication assistance, access to community resources, and social support.

Conclusions: CHWs play a variety of roles in helping patients overcome barriers to diabetes control and can be successfully integrated into a health care system's care coordination strategy.

Publication types

  • Evaluation Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Blood Glucose / metabolism
  • Community Health Workers* / organization & administration
  • Community Health Workers* / standards
  • Cooperative Behavior
  • Delivery of Health Care
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes Mellitus, Type 2 / prevention & control*
  • Female
  • Glycated Hemoglobin A / metabolism
  • Health Behavior*
  • Health Education* / organization & administration
  • Health Education* / standards
  • Health Services Accessibility
  • Humans
  • Male
  • Medication Adherence / statistics & numerical data*
  • Middle Aged
  • Patient Education as Topic
  • Primary Health Care* / organization & administration
  • Program Evaluation
  • Quality of Health Care
  • Self Care*
  • Social Support
  • Socioeconomic Factors
  • Surveys and Questionnaires
  • Texas / epidemiology

Substances

  • Blood Glucose
  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human