Impact of a community health workers-led structured program on blood glucose control among latinos with type 2 diabetes: the DIALBEST trial
| Autor: | Mariana C. Calle, Grace Kollannor-Samuel, Maria Luz Fernandez, Sonia Vega-López, Fatma M. Shebl, Grace Damio, Rafael Pérez-Escamilla, Sofia Segura-Pérez, Darrin D'Agostino, Jyoti Chhabra |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Blood Glucose Male medicine.medical_specialty Endocrinology Diabetes and Metabolism Blood lipids Type 2 diabetes law.invention Medication Adherence Diabetes Complications Young Adult Randomized controlled trial Patient Education as Topic law Diabetes mellitus Internal medicine Blood Glucose Self-Monitoring Patient-Centered Care Internal Medicine medicine Humans Healthcare Disparities Life Style Glycemic 2. Zero hunger Advanced and Specialized Nursing Community Health Workers Glycated Hemoglobin Patient Care Team medicine.diagnostic_test business.industry Hispanic or Latino Anthropometry Middle Aged medicine.disease Health Disparities in Diabetes Lipids 3. Good health Self Care Treatment Outcome Diabetes Mellitus Type 2 Hypertension Physical therapy Female Lipid profile business Delivery of Health Care |
| Zdroj: | Diabetes Care |
| ISSN: | 1935-5548 |
| Popis: | OBJECTIVE Latinos with type 2 diabetes (T2D) face major healthcare access and disease management disparities. We examined the impact of the Diabetes Among Latinos Best Practices Trial (DIALBEST), a community health worker (CHW)–led structured intervention for improving glycemic control among Latinos with T2D. RESEARCH DESIGN AND METHODS A total of 211 adult Latinos with poorly controlled T2D were randomly assigned to a standard of healthcare (n = 106) or CHW (n = 105) group. The CHW intervention comprised 17 individual sessions delivered at home by CHWs over a 12-month period. Sessions addressed T2D complications, healthy lifestyles, nutrition, healthy food choices and diet for diabetes, blood glucose self-monitoring, and medication adherence. Demographic, socioeconomic, lifestyle, anthropometric, and biomarker (HbA1c, fasting blood glucose, and lipid profile) data were collected at baseline and 3, 6, 12, and 18 months (6 months postintervention). Groups were equivalent at baseline. RESULTS Participants had high HbA1c at baseline (mean 9.58% [81.2 mmol/mol]). Relative to participants in the control group, CHWs had a positive impact on net HbA1c improvements at 3 months (−0.42% [−4.62 mmol/mol]), 6 months (−0.47% [−5.10 mmol/mol]), 12 months (−0.57% [−6.18 mmol/mol]), and 18 months (−0.55% [−6.01 mmol/mol]). The overall repeated-measures group effect was statistically significant (mean difference −0.51% [−5.57 mmol/mol], 95% CI −0.83, −0.19% [−9.11, −2.03 mmol/mol], P = 0.002). CHWs had an overall significant effect on fasting glucose concentration that was more pronounced at the 12- and 18-month visits. There was no significant effect on blood lipid levels, hypertension, and weight. CONCLUSIONS DIALBEST is an effective intervention for improving blood glucose control among Latinos with T2D. |
| Databáze: | OpenAIRE |
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