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Randomized Controlled Trial
. 2011 Dec;101(12):2253-60.
doi: 10.2105/AJPH.2010.300106. Epub 2011 Jun 16.

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

Michael S Spencer  1 , Ann-Marie Rosland, Edith C Kieffer, Brandy R Sinco, Melissa Valerio, Gloria Palmisano, Michael Anderson, J Ricardo Guzman, Michele Heisler
Affiliations
Randomized Controlled Trial

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

Michael S Spencer et al. Am J Public Health. 2011 Dec.

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.

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Figures

FIGURE 1
FIGURE 1
Study participant flow diagram of enrollment and loss to follow-up: REACH Detroit, 2004–2006. Note. FHA = family health advocate.
FIGURE 2
FIGURE 2
Unadjusted decreases in hemoglobin A1c levels from baseline to 6-month follow-up, by intervention arm with 95% confidence intervals: REACH Detroit, 2004–2006.
See this image and copyright information in PMC

References

    1. Healthy People 2010: Understanding and Improving Health. Washington, DC: US Dept of Health and Human Services; 2000.
    1. Flegal K, Ezzati T, Harris M, et al. Prevalence of diabetes in Mexican Americans, Cubans and Puerto Ricans from the Hispanic Health and Nutrition Examination Survey, 1982–1984. Diabetes Care. 1991;14(7):628–638. - PubMed
    1. Mokdad AH, Bowman BA, Ford ES, Vinicor F, Marks JS, Kaplan JP. The continuing epidemics of obesity and diabetes in the United States. JAMA. 2001;286(10):1195–1200. - PubMed
    1. Harris MI, Eastman RC, Cowie CC, Flegal KM, Eberhardt MS. Racial and ethnic differences in glycemic control of adults with type 2 diabetes. Diabetes Care. 1999;22(3):403–408. - PubMed
    1. Karter AJ, Ferrara A, Liu JY, Moffet HH, Ackerson LM, Selby JV. Ethnic disparities in diabetic complications in an insured population. JAMA. 2002;287(19):2519–2527. - PubMed

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