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
. 2013 Jul;36(7):1947-53.
doi: 10.2337/dc12-1969. Epub 2013 Feb 7.

Nurse-community health worker team improves diabetes care in American Samoa: results of a randomized controlled trial

Judith D DePue  1 , Shira Dunsiger, Andrew D Seiden, Jeffrey Blume, Rochelle K Rosen, Michael G Goldstein, Ofeira Nu'usolia, John Tuitele, Stephen T McGarvey
Affiliations
Randomized Controlled Trial

Nurse-community health worker team improves diabetes care in American Samoa: results of a randomized controlled trial

Judith D DePue et al. Diabetes Care. 2013 Jul.

Abstract

Objective: To evaluate the effectiveness of a culturally adapted, primary care-based nurse-community health worker (CHW) team intervention to support diabetes self-management on diabetes control and other biologic measures.

Research design and methods: Two hundred sixty-eight Samoan participants with type 2 diabetes were recruited from a community health center in American Samoa and were randomly assigned by village clusters to the nurse-CHW team intervention or to a wait-list control group that received usual care.

Results: Participants had a mean age of 55 years, 62% were female, mean years of education were 12.5 years, 41% were employed, and mean HbA1c was 9.8% at baseline. At 12 months, mean HbA1c was significantly lower among CHW participants, compared with usual care, after adjusting for confounders (b = -0.53; SE = 0.21; P = 0.03). The odds of making a clinically significant improvement in HbA1c of at least 0.5% in the CHW group was twice the odds in the usual care group after controlling for confounders (P = 0.05). There were no significant differences in blood pressure, weight, or waist circumference at 12 months between groups.

Conclusions: A culturally adapted nurse-CHW team intervention was able to significantly improve diabetes control in the U.S. Territory of American Samoa. This represents an important translation of an evidence-based model to a high-risk population and a resource-poor setting.

Trial registration: ClinicalTrials.gov NCT00850824.

PubMed Disclaimer

Figures

Figure 1
Figure 1
CONSORT diagram of recruitment and retention. T2, type 2.
See this image and copyright information in PMC

References

    1. Census US. The Native Hawaiian and Other Pacific Islander Population: 2010 Census Briefs. Available from http://www.census.gov/prod/cen2010/briefs/c2010br-12.pdf Accessed July 27 2012
    1. Keighley ED, McGarvey ST, Quested C, et al. Nutrition and health in modernizing Samoans: Temporal trends and adaptive perspectives. In Health Change in the Asia-Pacific Region. Ohtsuka R, Ulijaszek SJ, Eds. New York, Cambridge University Press, 2007, p. 142–191
    1. Dibello JR, Baylin A, Viali S, Tuitele J, Bausserman L, McGarvey ST. Adiponectin and type 2 diabetes in Samoan adults. Am J Hum Biol 2009;21:389–391 - PMC - PubMed
    1. National Diabetes Information Clearing House. National diabetes statistics, 2011. Available from http://diabetes.niddk.nih.gov//dm/pubs/statistics/DM_Statistics_508.pdf Accessed 20 April 2012
    1. Madon T, Hofman KJ, Kupfer L, Glass RI. Public health. Implementation science. Science 2007;318:1728–1729 - PubMed

Publication types

Associated data