Promotora diabetes intervention for Mexican Americans

Abstract

Purpose: The purpose of this randomized controlled trial is to determine the effectiveness of an intervention led by promotoras (community lay workers) on the glycemic control, diabetes knowledge, and diabetes health beliefs of Mexican Americans with type 2 diabetes living in a major city on the Texas-Mexico border.

Methods: One hundred fifty Mexican American participants were recruited at a Catholic faith-based clinic and randomized into 2 groups. Personal characteristics, acculturation, baseline A1C level, diabetes knowledge, and diabetes health beliefs were measured. The intervention was culturally specific and consisted of participative group education, telephone contact, and follow-up using inspirational faith-based health behavior change postcards. The A1C levels, diabetes knowledge, and diabetes health beliefs were measured 3 and 6 months postbaseline, and the mean change between the groups was analyzed.

Results: The 80% female sample, with a mean age of 58 years, demonstrated low acculturation, income, education, health insurance coverage, and strong Catholicism. No significant changes were noted at the 3-month assessment, but the mean change of the A1C levels, F(1, 148) = 10.28, P < .001, and the diabetes knowledge scores, F(1, 148) = 9.0, P < .002, of the intervention group improved significantly at 6 months, adjusting for health insurance coverage. The health belief scores decreased in both groups.

Conclusions: The intervention resulted in decreased A1C levels and increased diabetes knowledge, suggesting that using promotoras as part of an interdisciplinary team can result in positive outcomes for Mexican Americans who have type 2 diabetes. Clinical implications and recommendations for future research are suggested.