Interventions that utilize community health workers for diabetes prevention, typically implemented in underserved communities, can improve health and reduce health disparities for adults with diabetes, according to a recent report released by a CDC task force.
The Community Preventive Services Task Force is recommending interventions that engage community health workers for diabetes prevention to improve glycemic control and weight-related outcomes among people at increased risk for type 2 diabetes. Some evidence suggests interventions may reduce rates of progression from prediabetes to type 2 diabetes, although more research is needed, the report noted. The task force finding is based on evidence from a Community Guide systematic review of 22 studies conducted through May 2015.
Community health workers are defined as front-line public health workers who serve as a bridge between underserved communities and health care systems. They typically are from or have a unique understanding of the community served, and they often receive on-the-job training and work without professional titles. Organizations may hire paid community health workers or recruit volunteers.
In the review, the task force evaluated the effectiveness of interventions in which community health workers connected with community groups or individuals who had one or more risk factors for type 2 diabetes. Included studies evaluated interventions that engaged community health workers as health education providers (n = 22); outreach, enrollment and information agents (n = 6); members of care delivery teams (n = 4); and patient navigators (n = 3).
Findings showed that interventions utilizing community health workers resulted in improved HbA1c, weight-related outcomes and rates of progression to type 2 diabetes, although the report noted that data on reduced progression came from three studies with small sample sizes.
The report also evaluated intervention effectiveness on cardiovascular risk factors, noting that participants may benefit from lifestyle modification if lipid and blood pressure measurements were not elevated, as medical treatment was not part of any intervention. Increases in physical activity and improvements in nutrition were seen across studies.
“In this body of evidence, positive, significant changes were seen in weight loss, indicating an improvement in diet and physical activity behaviors,” the report stated. “However, evidence was mixed for improvements in other risk factors for [CV] disease, specifically, [BP] and cholesterol. More comparative studies are needed.” – by Regina Schaffer
For more information:
The task force report can be found at https://www.thecommunityguide.org/findings/diabetes-interventions-engaging-community-health-workers.