Health effectiveness of community health workers as a diabetes self-management intervention

Diab Vasc Dis Res. 2017 Jul;14(4):316-326. doi: 10.1177/1479164117696229. Epub 2017 Mar 23.

Abstract

Objective: To evaluate the health effectiveness of community health workers among three groups (intervention, attentional control and control groups) of Hispanic adults with uncontrolled (HbA1c >8%) type 2 diabetes mellitus.

Methods: This was a randomized clinical trial involving 180 English- and Spanish-speaking Hispanic individuals with uncontrolled type 2 diabetes mellitus, 40-74 years of age, who received diabetes care at an outpatient, public, urban hospital. Repeated-measures analysis of variance was used to evaluate the effect of time and group on the primary outcome measure and secondary outcomes. Group differences in the percentage of participants achieving at least 1% reduction in HbA1c levels were assessed using chi-square tests.

Results: Patients' ages ranged from 44 to 74 years, 40% were male, 97% preferred Spanish and seven Spanish-speaking countries were identified as country of origin. Relative to the control and attentional control groups, the intervention group showed greater HbA1c reduction from baseline to 12 months and was the group with the highest percentage of participants showing 1% or more HbA1c reduction.

Conclusion: Integration of community health workers improved disease control for patients with type 2 diabetes mellitus during the intervention phase. Peer-driven/interactive ways to sustain diabetes control need to be explored.

Keywords: Diabetes; Hispanics; community health workers; diabetes self-management.

Publication types

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

MeSH terms

  • Adult
  • Aged
  • Analysis of Variance
  • Biomarkers / blood
  • Blood Pressure
  • Chi-Square Distribution
  • Community Health Services*
  • Community Health Workers*
  • Delivery of Health Care, Integrated*
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / diagnosis
  • Diabetes Mellitus, Type 2 / ethnology
  • Diabetes Mellitus, Type 2 / therapy*
  • Down-Regulation
  • Female
  • Glycated Hemoglobin A / metabolism*
  • Health Knowledge, Attitudes, Practice / ethnology
  • Hispanic Americans
  • Hospitals, Public
  • Hospitals, Urban
  • Humans
  • Male
  • Middle Aged
  • New York City / epidemiology
  • Outpatient Clinics, Hospital
  • Patient Education as Topic*
  • Self-Management / methods*
  • Time Factors
  • Treatment Outcome
  • Triglycerides / blood

Substances

  • Biomarkers
  • Glycated Hemoglobin A
  • Triglycerides
  • hemoglobin A1c protein, human