Nurse–Community Health Worker Team Improves Diabetes Care in American Samoa
| Autor: | Stephen T. McGarvey, Jeffrey D. Blume, Andrew Seiden, Michael G. Goldstein, Ofeira Nu'usolia, Shira Dunsiger, Rochelle K. Rosen, John Tuitele, Judith D. DePue |
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| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: |
Research design
Gerontology Adult Male medicine.medical_specialty Waist Endocrinology Diabetes and Metabolism Population 030209 endocrinology & metabolism Type 2 diabetes law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial Community health center law Internal Medicine medicine Humans 030212 general & internal medicine education Original Research Aged Advanced and Specialized Nursing Community Health Workers Patient Care Team education.field_of_study Primary Health Care business.industry Clinical Care/Education/Nutrition/Psychosocial Research Middle Aged medicine.disease language.human_language 3. Good health American Samoa Diabetes Mellitus Type 2 Family medicine Community health language Samoan Female business |
| Zdroj: | Diabetes Care |
| ISSN: | 1935-5548 0149-5992 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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