Community Health Worker-Led Intervention Beneficial in T2D

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Participants in the community health worker intervention had greater decreases in HbA1c and in diabetes distress.
Participants in the community health worker intervention had greater decreases in HbA1c and in diabetes distress.

HealthDay News — A community health worker (CHW)-led diabetes self-management education (DSME) program is associated with sustained improvement in hemoglobin A1c (HbA1c), according to a study published in Diabetes Care.

Michael S. Spencer, Ph.D., from the University of Michigan in Ann Arbor, and colleagues randomized 222 Latino adults with type 2 diabetes and poor glycemic control to a CHW-led, six-month DSME program or enhanced usual care (EUC).

Participants randomized to the CHW-led DSME were further randomized after the program to 12 months of CHW-delivered monthly telephone outreach or 12 months of weekly group sessions delivered by peer leaders (PLs; CHW+PL).

The researchers found that at the six-month follow-up, compared with EUC, participants in the CHW intervention had greater decreases in HbA1c (−0.45) and in diabetes distress (−0.3). Improvements in HbA1c were maintained at 12 and 18 months in CHW+PL participants; CHW-only participants maintained improvements in diabetes distress at 12 and 18 months.

Compared with EUC, CHW+PL participants also had significantly fewer depressive symptoms at 18 months (−2.2). Relative to EUC, participants in CHW-led DSME had significant improvements in diabetes social support and in understanding of diabetes self-management at six months; these effects were not maintained at 18 months.

"This study demonstrates the effectiveness of a six-month CHW intervention on key diabetes outcomes and of a volunteer PL program in sustaining key achieved gains," the authors write.

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