Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2012 Mar;33(2):369-77.
doi: 10.1016/j.cct.2011.10.013. Epub 2011 Nov 15.

The Mexican-American Trial of Community Health workers (MATCH): design and baseline characteristics of a randomized controlled trial testing a culturally tailored community diabetes self-management intervention

Steven K Rothschild  1 , Molly A Martin, Susan M Swider, Carmen T Lynas, Elizabeth F Avery, Imke Janssen, Lynda H Powell
Affiliations
Randomized Controlled Trial

The Mexican-American Trial of Community Health workers (MATCH): design and baseline characteristics of a randomized controlled trial testing a culturally tailored community diabetes self-management intervention

Steven K Rothschild et al. Contemp Clin Trials. 2012 Mar.

Abstract

Objectives: Community Health Workers (CHWs) have been recommended to reduce diabetes disparities, but few robust trials of this approach have been conducted. Limitations of prior studies include: unspecified a priori outcomes; lack of blinded outcome assessments; high participant attrition rates; and lack of attention to intervention fidelity. These limitations reflect challenges in balancing methodologic rigor with the needs of vulnerable populations. The Mexican-American Trial of Community Health workers (MATCH) was a blinded randomized controlled trial testing CHW efficacy in improving physiologic outcomes and self-management behaviors among Mexican-Americans with type 2 diabetes. This paper describes methods used to overcome limitations of prior studies.

Research design and methods: The primary aim was to determine if a CHW intervention would result in significant reductions in Hemoglobin A1c and rates of uncontrolled blood pressure. 144 Mexican-Americans with diabetes were randomized. The intervention consisted of self-management training delivered by CHWs over a 24-month period; the comparison population received identical information via bilingual newsletter. Blinded research assistants completed assessments at baseline, 12 months, and 24 months post-randomization.

Results: The MATCH cohort was characterized by low acculturation and socioeconomic status. Study participants had low rates of medication adherence and glucose monitoring. 70% had poor glycemic control with A1c levels over 7.0, and 57.3% had blood pressures worse than ADA target levels (<130/80).

Conclusions: MATCH preserved community sensitivity and methodologic rigor. The study's attention to intervention fidelity, behavioral attention control, blinded outcomes assessment, and strategies to enhance participant retention can be replicated by researchers testing culturally-tailored CHW interventions.

PubMed Disclaimer

Figures

FIGURE 1
FIGURE 1
FIGURE 2
FIGURE 2
Variables Measured At Time Of Randomization And 1-Year And 2-Year Follow-Up
See this image and copyright information in PMC

References

    1. Centers for Disease Control and Prevention. National diabetes fact sheet: General information and national estimates on diabetes in the united states, 2007. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention; 2008.
    1. Caballero AE. Type 2 diabetes in the hispanic or latino population: Challenges and opportunities. Current Opinion in Endocrinology, Diabetes & Obesity. 2007 Apr;14(2):151–7. - PubMed
    1. Coronado GD, Thompson B, Tejeda S, Godina R. Attitudes and beliefs among mexican americans about type 2 diabetes. Journal of Health Care for the Poor & Underserved. 2004 Nov;15(4):576–88. - PubMed
    1. Glazier RH, Bajcar J, Kennie NR, Willson K. A systematic review of interventions to improve diabetes care in socially disadvantaged populations YR 2006 FD july JF JO SP 1675 OP 1688 DO 10.2337/dc05-1942 VO 29 IS 7 UL. AB Diabetes Care. 2006 July;29:1675–88. http://care.diabetesjournals.org/content/29/7/1675.abstract. - PubMed
    1. Rosenthal EL. A summary of the national community health advisor study. Baltimore: Annie E. Casey Foundation; 1998.

Publication types

MeSH terms

Substances