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Randomized Controlled Trial
. 2014 Aug;104(8):1540-8.
doi: 10.2105/AJPH.2013.301439. Epub 2013 Aug 15.

Mexican American trial of community health workers: a randomized controlled trial of a community health worker intervention for Mexican Americans with type 2 diabetes mellitus

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

Mexican American trial of community health workers: a randomized controlled trial of a community health worker intervention for Mexican Americans with type 2 diabetes mellitus

Steven K Rothschild et al. Am J Public Health. 2014 Aug.

Abstract

Objectives: We assessed whether community health workers (CHWs) could improve glycemic control among Mexican Americans with diabetes.

Methods: We recruited 144 Mexican Americans with type 2 diabetes between January 2006 and September 2008 into the single-blinded, randomized controlled Mexican American Trial of Community Health Workers (MATCH) and followed them for 2 years. Participants were assigned to either a CHW intervention, delivering self-management training through 36 home visits over 2 years, or a bilingual control newsletter delivering the same information on the same schedule.

Results: Intervention participants showed significantly lower hemoglobin A1c levels than control participants at both year 1 Δ = -0.55; P = .021) and year 2 (Δ = -0.69; P = .005). We observed no effect on blood pressure control, glucose self-monitoring, or adherence to medications or diet. Intervention participants increased physical activity from a mean of 1.63 days per week at baseline to 2.64 days per week after 2 years.

Conclusions: A self-management intervention delivered by CHWs resulted in sustained improvements in glycemic control over 2 years among Mexican Americans with diabetes. MATCH adds to the growing body of evidence supporting the use of CHWs to reduce diabetes-related health disparities.

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Figures

FIGURE 1—
FIGURE 1—
Mixed-effects linear model analysis with fixed effects only and time, treatment arm, time–by–treatment arm interaction, and baseline hemoglobin A1c among participants with diabetes mellitus: Mexican American Trial of Community Health Workers, Chicago, IL, 2006–2008. Note. Whiskers indicate 95% confidence intervals. *P = .02; **P = .005.
FIGURE 2—
FIGURE 2—
Percentage of participants with diabetes mellitus who (a) adhered ≥ 80% to drug regimen and (b) checked glucose ≥ 8/10 days: Mexican American Trial of Community Health Workers, Chicago, IL, 2006–2008. Note. Whiskers indicate 95% confidence intervals.
FIGURE 3—
FIGURE 3—
Number of days/week that participants with diabetes mellitus (a) self-reported exercise and (b) consumed fruits and vegetables: Mexican American Trial of Community Health Workers, Chicago, IL, 2006–2008. Note. Whiskers indicate 95% confidence intervals.
See this image and copyright information in PMC

References

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