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



The study site was an 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 from baseline to 6 months and 1 year. Statistically significant changes were correlated with frequency of community health worker contact.



The paired-sample t test showed significant reduction in glycosylated hemoglobin (HbA1c) 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 HbA1c than men at 1 year. Patients with a higher frequency of community health worker contact showed a greater decline in HbA1c level.



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.
Thompson
Joan R
JR
La Clinica de La Raza, Oakland, California
Horton
Claire
C
La Clinica de La Raza, Oakland, California
Flores
Carlos
C
La Clinica de La Raza, Oakland, California
D002140:California; D003151:Community Health Centers; D003920:Diabetes Mellitus / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D017058:Mexican Americans; D008875:Middle Aged; D010353:Patient Education as Topic; D012648:Self Care; D012959:Socioeconomic Factors