Advancing diabetes self-management in the Mexican American population - A community health worker model in a primary care setting

Purpose The purpose of this study was to pilot test the effectiveness of health promoters trained in the transtheoretical model of change to provide diabetes management education and Support to Mexican Americans in a primary care setting. Methods The Study site was all urban community health center in Oakland, California. This Study reports on 142 patients who were enrolled for at least 1 year in the program. community health workers acted as extenders of the medical staff to facilitate behavior change, using patient-centered Counseling. This was a 1-group pretest/posttest pilot study. Descriptive statistics and the paired-sample t test were used to compare the change in clinical outcome measures front baseline to 6 months and 1 year. Statistically significant changes were correlated with frequency of community health worker contact. Results The paired-sample t test showed significant reduction in glycosylated hemoglobin (HbAlc) from baseline to 1 year (P < .004). Reductions were also seen in low-density lipoprotein cholesterol and blood pressure, but they were not statistically significant. When stratified by gender. women showed a greater reduction in HbA 1c than men at 1 year. Patients with a higher frequency of community health worker contact showed a greater decline in HbA 1c level. Conclusions The pilot study demonstrates that community health workers, as an integral part of the health care team, are effective agents in providing self-management support to persons with diabetes.