Community Diabetes Education (CoDE) for uninsured Mexican Americans: A randomized controlled trial of a culturally tailored diabetes education and management program led by a community health worker

Prezio, Elizabeth A.; Cheng, Dunlei; Balasubramanian, Bijal A.; Shuval, Kerem; Kendzor, Darla E.; Culica, Dan

doi:10.1016/j.diabres.2013.01.027

Cited by 90 publications

(173 citation statements)

References 32 publications

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“…Participant attrition rates were high in some studies, reaching 50 % in the usual care (control) group of the trial performed by Babamoto et al 14 Only nine trials had a clinically meaningful follow-up of at least 12 months. [10][11][12][13][20][21][22][23][24] Of note, those nine studies also exhibited higher quality, and substantially lower risk of bias, than shorter-term studies. For example, all of them described the standardized method applied to measure A1c, and they all followed the intention to treat principle to analyze A1c changes.…”

Section: Resultsmentioning

confidence: 96%

“…[8][9][10][11][12][13][14][19][20][21][22][23][24] Table 1 describes the basic characteristics of those thirteen trials, including the setting for participant recruitment, duration of the study, and ethnicity of the study populations. Most of them studied minority populations, either AfricanAmerican, 13 Hispanics, 9,10,12,14,19,21,23,24 or both. 8 Allen et al recruited some White participants (21 % of their study sample), but the majority of their participants were AfricanAmerican.…”

Section: Resultsmentioning

confidence: 99%

“…For example, in the study by Prezio et al, the CHW was professionally certified by the state of Texas, and received 27 hours of additional instruction from Certified Diabetes Educators, Registered Dietitians, and an endocrinologist. 23 She was also required to pass a written examination and a clinical examination supervised by the community diabetes instructors. In the MATCH (Mexican American Trial of Community Health Workers) study, the CHWs underwent stepwise training in Spanish.…”

Section: Resultsmentioning

confidence: 99%

“…In addition, those longer-term studies tended to have larger samples that enhanced their statistical power, and either achieved a balanced distribution of baseline characteristics across the randomized groups, or adjusted appropriately for them in the analysis. [10][11][12][13][20][21][22][23][24] …”

Section: Resultsmentioning

confidence: 99%

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Community Health Worker Interventions to Improve Glycemic Control in People with Diabetes: A Systematic Review and Meta-Analysis

et al. 2015

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OBJECTIVES:We set out to review the efficacy of Community Health Worker (CHW) interventions to improve glycemia in people with diabetes. METHODS: Data sources included the Cochrane Central Register of Controlled Trials, Medline, clinicaltrials.gov, Google Scholar, and reference lists of previous publications. We reviewed randomized controlled trials (RCTs) that assessed the efficacy of CHW interventions, as compared to usual care, to lower hemoglobin A1c (A1c). Two investigators independently reviewed the RCTs and assessed their quality. Only RCTs with a follow-up of at least 12 months were meta-analyzed. A random effects model was used to estimate, from unadjusted withingroup mean reductions, the standardized mean difference (SMD) in A1c achieved by the CHW intervention, beyond usual care. RESULTS: Thirteen RCTs were included in the narrative review, and nine of them, which had at least 12 months of follow-up, were included in the meta-analysis. Publication bias could not be ruled-out due to the small number of trials. Outcome heterogeneity was moderate (I 2 = 37 %). The SMD in A1c (95 % confidence interval) was 0.21 (0.11-0.32). Meta-regression showed an association between higher baseline A1c and a larger effect size. CONCLUSIONS: CHW interventions showed a modest reduction in A1c compared to usual care. A1c reduction was larger in studies with higher mean baseline A1c. Caution is warranted, given the small number of studies.

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Section: Resultsmentioning

confidence: 96%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Community Health Worker Interventions to Improve Glycemic Control in People with Diabetes: A Systematic Review and Meta-Analysis

et al. 2015

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“…12,[16][17][18] We trained lay leaders to lead the intervention classes since several studies have noted strong evidence for peer-led group self-management programs in improving self-management and clinical outcomes. 13,[19][20][21][22][23][24][25][26][27] To our knowledge, ours is the first study to evaluate the feasibility, acceptability, and clinical impact of a church-based diabetes selfmanagement intervention among Latinos with diabetes.…”

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confidence: 99%

Picture Good Health: A Church-Based Self-Management Intervention Among Latino Adults with Diabetes

et al. 2015

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BACKGROUND: Churches may provide a familiar and accessible setting for chronic disease self-management education and social support for Latinos with diabetes. OBJECTIVE: We assessed the impact of a multi-faceted church-based diabetes self-management intervention on diabetes outcomes among Latino adults. DESIGN: This was a community-based, randomized controlled, pilot study. SUBJECTS: One-hundred adults with self-reported diabetes from a Midwestern, urban, low-income MexicanAmerican neighborhood were included in the study. INTERVENTIONS: Intervention participants were enrolled in a church-based diabetes self-management program that included eight weekly group classes led by trained lay leaders. Enhanced usual care participants attended one 90-minute lecture on diabetes selfmanagement at a local church. OUTCOME MEASURES: The primary outcome was change in glycosylated hemoglobin (A1C). Secondary outcomes included changes in low-density lipoproteins (LDL), blood pressure, weight, and diabetes self-care practices. KEY RESULTS: Participants' mean age was 54±12 years, 81 % were female, 98 % were Latino, and 51 % were uninsured. At 3 months, study participants in both arms decreased their A1C from baseline (−0.32 %, 95 % confidence interval [CI]: -0.62, -0.02 %). The difference in change in A1C, LDL, blood pressure and weight from baseline to 3-month and 6-month follow-up was not statistically significant between the intervention and enhanced usual care groups. Intervention participants

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Culturally appropriate health education for people in ethnic minority groups with type 2 diabetes mellitus

Attridge

Creamer

Ramsden

et al. 2014

Cochrane Database of Systematic Reviews

145

154

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Culturally appropriate health education has short- to medium-term effects on glycaemic control and on knowledge of diabetes and healthy lifestyles. With this update (six years after the first publication of this review), a greater number of RCTs were reported to be of sufficient quality for inclusion in the review. None of these studies were long-term trials, and so clinically important long-term outcomes could not be studied. No studies included an economic analysis. The heterogeneity of the studies made subgroup comparisons difficult to interpret with confidence. Long-term, standardised, multi-centre RCTs are needed to compare different types and intensities of culturally appropriate health education within defined ethnic minority groups, as the medium-term effects could lead to clinically important health outcomes, if sustained.

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Community Diabetes Education (CoDE) for uninsured Mexican Americans: A randomized controlled trial of a culturally tailored diabetes education and management program led by a community health worker

Cited by 90 publications

References 32 publications

Community Health Worker Interventions to Improve Glycemic Control in People with Diabetes: A Systematic Review and Meta-Analysis

Community Health Worker Interventions to Improve Glycemic Control in People with Diabetes: A Systematic Review and Meta-Analysis

Picture Good Health: A Church-Based Self-Management Intervention Among Latino Adults with Diabetes

Culturally appropriate health education for people in ethnic minority groups with type 2 diabetes mellitus

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