Initiative yielded modest benefit in diabetes care among Hispanics

A modest improvement in HbA1c levels was seen in Hispanic adults with diabetes after visits by community health workers compared with usual care, according to data from the Northern Manhattan Diabetes Community Outreach Project.

No improvement was witnessed in systolic or diastolic blood pressures and LDL levels after the study — one of only a handful that aimed to find the efficacy of such interventions in minority populations.

The randomized controlled trial involved 260 Hispanic participants, aged 35 to 70 years, with poorly controlled type 2 diabetes living in northern Manhattan. For 12 months, 181 participants received a community health worker (CHW) intervention and 179 received slight enhancements to their usual care.

The intervention included one-on-one visits to assess existing barriers to health care, group visits and telephone follow-up. The control group received Spanish-language educational material, a cookbook and quarterly phone calls to ensure they received the information.

“We did observe a no significant trend toward improved [HbA1c], and a post hoc analysis suggested that a modified CHW intervention, maximizing the use of phone calls, could result in better adherence and greater efficacy in populations facing socioeconomic hardship,” the researchers wrote.

Intervention fidelity, measured as the number of CHW contacts (visits, calls, groups and nutritional education), was predictive of a reduction in HbA1c levels in participants. And when assessed separately, phone contacts were linked to greater HbA1c reduction (P=.04). The same analysis showed increased CHW service resulted in higher systolic BP, although the outcomes were not significant, according to the researchers.

Disclosure: The researchers report no relevant financial disclosures.