Roles, responsibilities and characteristics of lay community health workers involved in diabetes prevention programmes: A systematic review

Abstract

AimTo examine the characteristics of community health workers (CHWs) involved in diabetes prevention programmes (DPPs) and their contributions to expected outcomes.MethodsElectronic databases including PubMed-MEDLINE, EBSCOHost, and SCOPUS/EMBASE were searched for studies published between January 2000 and March 2016. All studies that used CHWs to implement DPP in ≥18-year-old participants without diabetes but at high risk for developing the condition, irrespective of the study design, setting or outcomes measured, were included. Results were synthesized narratively.ResultsForty papers of 30 studies were identified. Studies were mainly community-based and conducted in minority populations in USA. Sample sizes ranged from 20 participants in a single community to 2369 participants in 46 communities. Although CHWs were generally from the local community, their qualifications, work experience and training received differed across studies. Overall the training was culturally sensitive and/or appropriate, covering topics such as the importance of good nutrition and the benefits of increased physical activity, communication and leadership. CHWs delivered a variety of interventions and also screened or recruited participants. The shared culture and language between CHWs and participants likely contributed to better programme implementation and successful outcomes.ConclusionsThe complexity of DPPs and the diverse CHW roles preclude attributing specific outcomes to CHW involvement. Nevertheless, documenting potential CHW roles and the relevant training required may optimise CHW contributions and facilitate their involvement in DPPs in the future.

Food pantries as partners in population health: Assessing organizational and personnel readiness for delivering nutrition-focused charitable food assistance

“…Lay community health workers have been used in a variety of primary and community-based health-care settings for the delivery of disease prevention and self-management programs with the added advantage of peer support. [33][34][35] Our study found that the majority of food pantry personnel have adequate health literacy and many have a personal history of food assistance program use and/or a diagnosis with diabetes or hypertension, which makes these individuals ideal candidates for a similar peer support role in food pantry-based health programs. Furthermore, food bank-sponsored trainings for food pantry workers on health-related topics may be a natural extension for many food banks that have traditionally offered pantry personnel training programs, primarily on the topics of food safety [36][37][38] or building agency capacity, 36-39 though some provide nutrition education and healthful food stocking strategies to personnel.…”

Review of Ongoing Activities and Challenges to Improve the Care of Patients With Type 2 Diabetes Across Africa and the Implications for the Future

“…We did not perform a systematic review since there have been an appreciable number of recent publications, including systematic reviews, discussing ongoing research in this area and its implications including current prevalence rates, health system concerns, as well as possible policies and ways to improve future care (Brouwer et al, 2015;Agyemang et al, 2016;Hill et al, 2017;Jaam et al, 2017;Pastakia et al, 2017;Issaka et al, 2018;Nuche-Berenguer and Kupfer, 2018;Owolabi et al, 2018;Stephani et al, 2018;Wagnew et al, 2018;Asmelash and Asmelash, 2019;Farmer et al, 2019;Manne-Goehler et al, 2019;Mapa-Tassou et al, 2019). In addition, a number of the references, especially regarding ongoing national activities, are typically only available on the Internet as some of these have only just been launched.…”

“…This includes appraising key issues associated with co-morbidities with infectious diseases such as HIV and the resultant implications. There have been a number of systematic reviews looking at key issues surrounding the management of patients with diabetes in Africa including initiatives to strengthen healthcare systems (Brouwer et al, 2015;Atun et al, 2017;Hill et al, 2017;Issaka et al, 2018;Jaam et al, 2017;Nuche-Berenguer and Kupfer, 2018;Ong et al, 2018;Owolabi et al, 2018;Stephani et al, 2018;Wagnew et al, 2018;Asmelash and Asmelash, 2019;Manne-Goehler et al, 2019). We are also aware of the recent NCD research conference for Africa to share evidence and identifying research priorities (Juma et al, 2019).…”

Recruitment, retention, and training of people with type 2 diabetes as diabetes prevention mentors (DPM) to support a healthcare professional-delivered diabetes prevention program: the Norfolk Diabetes Prevention Study (NDPS)

“…The use of lay volunteer health workers, or community health workers, to deliver lifestyle modification intervention in a clinical setting for people at high risk of type 2 diabetes, or with type 2 diabetes, is well described 9 17 40–43. These workers have generally been non-professional volunteers without a healthcare background, but with training to deliver a specific healthcare intervention to a familiar target population 9 17 39–43. It should be emphasized that the DPMs with type 2 diabetes in this study were not entirely representative of the general lay population, as 65% had some experience counseling or training prior to recruitment, and all had type 2 diabetes.…”

“…This is an attractive model in terms of limiting salary costs and expanding the prevention workforce with workers who usually share a common life experience,33 and people with type 2 diabetes are an obvious choice for this role. Only one other study has used people with type 2 diabetes as part of a diabetes prevention trial to prevent diabetes,44 although it is unknown if this translated into a lower type 2 diabetes incidence, but these studies frequently show improvements in surrogates for diabetes risk 9 17 40–43 45. In type 2 diabetes, available lay volunteer studies have generally been clinical interventions in high-income countries targeting minority diabetes populations in low-income settings 46.…”