Curr Diab Rep (2014) 14:558 DOI 10.1007/s11892-014-0558-1
LIFESTYLE MANAGEMENT TO REDUCE DIABETES/CARDIOVASCULAR RISK (EM VENDITTI, SECTION EDITOR)
Community Health Worker Interventions for Latinos With Type 2 Diabetes: a Systematic Review of Randomized Controlled Trials Tariana V. Little & Monica L. Wang & Eida M. Castro & Julio Jiménez & Milagros C. Rosal
Published online: 7 November 2014 # Springer Science+Business Media New York 2014
Abstract This systematic review aimed to synthesize glucose (HbA1c) outcomes of community health worker (CHW)-delivered interventions for Latinos with type 2 diabetes that were tested in randomized controlled trials and to summarize characteristics of the targeted populations and interventions, including the background, training, and supervision of the CHWs. Searches of PubMed and Google Scholar databases and references from selected articles identified 12 studies that met the inclusion criteria. Of these, seven reported statistically significant improvements in HbA1c. Study participants were largely low-income,
female, and Spanish-speaking and had uncontrolled diabetes. The CHWs led the interventions alone, in pairs, or as part of a team. Interventions varied considerably in session time, duration, and number. Most met standards for tailored, high-intensity interventions and half were theorybased. Overall, methodological quality was good but there were inconsistencies in the reporting of key information. Future research should report in greater detail CHW background, training, and supervision; examine factors associated with intervention effectiveness; and provide data on cost and cost-effectiveness. Keywords Community health worker . Randomized control trial . Type 2 diabetes . Hispanic . Culture . Literacy
This article is part of the Topical Collection on Lifestyle Management to Reduce Diabetes/Cardiovascular Risk T. V. Little Clinical and Population Health Research Program, Department of Quantitative Health Sciences, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA e-mail: [email protected] T. V. Little : M. C. Rosal (*) Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA e-mail: [email protected] M. L. Wang Department of Community Health Sciences, Boston University School of Public Health, 715 Albany St., Boston, MA 02118, USA e-mail: [email protected] E. M. Castro : J. Jiménez Department of Psychiatry, Ponce School of Medicine and Health Sciences, 388 Zona Ind Reparada 2, Ponce, PR 00716, USA E. M. Castro e-mail: [email protected] J. Jiménez e-mail: [email protected]
Introduction Compared to non-Latino Whites, Latinos have 1.7 times greater risk of developing type 2 diabetes (T2D) [1], a higher prevalence of diabetes (12 vs. 7 %) [2], and greater odds of diabetes-related complications and mortality [3]. In the overall US population and among US Latinos, T2D prevalence, morbidity, and mortality are inversely related to education, with those with less than a high school degree being at increased risk for poor outcomes [1, 2, 4]. Behavioral self-management is critical to prevention of diabetes complications [5], but difficult among Latinos due to patient factors, such as low literacy, limited English proficiency, and cultural differences, and healthcare system factors related to limited resources [6]. As a result, less than half of Latinos with T2D achieve ideal glycemic control, defined as hemoglobin A1c (HbA1c) levels
LIFESTYLE MANAGEMENT TO REDUCE DIABETES/CARDIOVASCULAR RISK (EM VENDITTI, SECTION EDITOR)
Community Health Worker Interventions for Latinos With Type 2 Diabetes: a Systematic Review of Randomized Controlled Trials Tariana V. Little & Monica L. Wang & Eida M. Castro & Julio Jiménez & Milagros C. Rosal
Published online: 7 November 2014 # Springer Science+Business Media New York 2014
Abstract This systematic review aimed to synthesize glucose (HbA1c) outcomes of community health worker (CHW)-delivered interventions for Latinos with type 2 diabetes that were tested in randomized controlled trials and to summarize characteristics of the targeted populations and interventions, including the background, training, and supervision of the CHWs. Searches of PubMed and Google Scholar databases and references from selected articles identified 12 studies that met the inclusion criteria. Of these, seven reported statistically significant improvements in HbA1c. Study participants were largely low-income,
female, and Spanish-speaking and had uncontrolled diabetes. The CHWs led the interventions alone, in pairs, or as part of a team. Interventions varied considerably in session time, duration, and number. Most met standards for tailored, high-intensity interventions and half were theorybased. Overall, methodological quality was good but there were inconsistencies in the reporting of key information. Future research should report in greater detail CHW background, training, and supervision; examine factors associated with intervention effectiveness; and provide data on cost and cost-effectiveness. Keywords Community health worker . Randomized control trial . Type 2 diabetes . Hispanic . Culture . Literacy
This article is part of the Topical Collection on Lifestyle Management to Reduce Diabetes/Cardiovascular Risk T. V. Little Clinical and Population Health Research Program, Department of Quantitative Health Sciences, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA e-mail: [email protected] T. V. Little : M. C. Rosal (*) Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA e-mail: [email protected] M. L. Wang Department of Community Health Sciences, Boston University School of Public Health, 715 Albany St., Boston, MA 02118, USA e-mail: [email protected] E. M. Castro : J. Jiménez Department of Psychiatry, Ponce School of Medicine and Health Sciences, 388 Zona Ind Reparada 2, Ponce, PR 00716, USA E. M. Castro e-mail: [email protected] J. Jiménez e-mail: [email protected]
Introduction Compared to non-Latino Whites, Latinos have 1.7 times greater risk of developing type 2 diabetes (T2D) [1], a higher prevalence of diabetes (12 vs. 7 %) [2], and greater odds of diabetes-related complications and mortality [3]. In the overall US population and among US Latinos, T2D prevalence, morbidity, and mortality are inversely related to education, with those with less than a high school degree being at increased risk for poor outcomes [1, 2, 4]. Behavioral self-management is critical to prevention of diabetes complications [5], but difficult among Latinos due to patient factors, such as low literacy, limited English proficiency, and cultural differences, and healthcare system factors related to limited resources [6]. As a result, less than half of Latinos with T2D achieve ideal glycemic control, defined as hemoglobin A1c (HbA1c) levels
