Details:

Alternative Title:
Prev Chronic Dis
Publisher's site:
http://dx.doi.org/10.5888/pcd14.160344
Personal Author:
Nelson, Karin ; Taylor, Leslie ; Silverman, Julie ; Kiefer, Meghan ; Hebert, Paul ; ... More +
Nelson, Karin ; Taylor, Leslie ; Silverman, Julie ; Kiefer, Meghan ; Hebert, Paul ; Lessler, Dan ; Krieger, James ; Less -
Description:
Introduction Community health workers (CHWs) can improve diabetes outcomes; however, questions remain about translating research findings into practical low-intensity models for safety-net providers. We tested the effectiveness of a home-based low-intensity CHW intervention for improving health outcomes among low-income adults with diabetes. Methods Low-income patients with glycated hemoglobin A1c (HbA1c) of 8.0% or higher in the 12 months before enrollment from 3 safety-net providers were randomized to a 12-month CHW-delivered diabetes self-management intervention or usual care. CHWs were based at a local health department. The primary outcome was change in HbA1c from baseline enrollment to 12 months; secondary outcomes included blood pressure and lipid levels, quality of life, and health care use. Results The change in HbA1c in the intervention group (n = 145) (unadjusted mean of 9.09% to 8.58%, change of −0.51) compared with the control group (n = 142) (9.04% to 8.71%, change of −0.33) was not significant (P = .54). In an analysis of participants with poor glycemic control (HbA1c >10%), the intervention group had a 1.23-point greater decrease in HbA1c compared with controls (P = .046). For the entire study population, we found a decrease in reported physician visits (P < .001) and no improvement in health-related quality of life (P = .07) in the intervention group compared with the control group. Conclusion A low-intensity CHW-delivered intervention to support diabetes self-management did not significantly improve HbA1c relative to usual care. Among the subgroup of participants with poor glycemic control (HbA1c >10% at baseline), the intervention was effective.
Subject:
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Original Research

Source:
Prev Chronic Dis. 14.
Pubmed ID:
28182863
Pubmed Central ID:
PMC5303652
Document Type:
Journal Article ;
Funding:
R18 DK088072/DK/NIDDK NIH HHS/United States ;
Collection(s):
Preventing Chronic Disease
Main Document Checksum:
[+]
urn:sha256:4f2240593b9ec54dc854a403e46fa5903d7ce879264e0e8d98e670610d44b92f
File Type:

Supporting Files

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