title: Effectiveness of a community health worker intervention among African American and Latino adults with type 2 diabetes: a randomized controlled trial.
abstract: OBJECTIVE
  We tested the effectiveness of a culturally tailored, behavioral theory-based community health worker intervention for improving glycemic control.
  
  
  METHODS
  We used a randomized, 6-month delayed control group design among 164 African American and Latino adult participants recruited from 2 health systems in Detroit, Michigan. Our study was guided by the principles of community-based participatory research. Hemoglobin A1c (HbA1c) level was the primary outcome measure. Using an empowerment-based approach, community health workers provided participants with diabetes self-management education and regular home visits, and accompanied them to a clinic visit during the 6-month intervention period.
  
  
  RESULTS
  Participants in the intervention group had a mean HbA1c value of 8.6% at baseline, which improved to a value of 7.8% at 6 months, for an adjusted change of -0.8 percentage points (P < .01). There was no change in mean HbA1c among the control group (8.5%). Intervention participants also had significantly greater improvements in self-reported diabetes understanding compared with the control group.
  
  
  CONCLUSIONS
  This study contributes to the growing evidence for the effectiveness of community health workers and their role in multidisciplinary teams engaged in culturally appropriate health care delivery.
authors.affiliation: University of Michigan, School of Social Work, Ann Arbor, MI 48109-1106, USA. spencerm@umich.edu
authors.forename: Michael S
authors.initials: MS
authors.lastname: Spencer
authors.forename: Ann-Marie
authors.initials: AM
authors.lastname: Rosland
authors.forename: Edith C
authors.initials: EC
authors.lastname: Kieffer
authors.forename: Brandy R
authors.initials: BR
authors.lastname: Sinco
authors.forename: Melissa
authors.initials: M
authors.lastname: Valerio
authors.forename: Gloria
authors.initials: G
authors.lastname: Palmisano
authors.forename: Michael
authors.initials: M
authors.lastname: Anderson
authors.forename: J Ricardo
authors.initials: JR
authors.lastname: Guzman
authors.forename: Michele
authors.initials: M
authors.lastname: Heisler
mesh_terms: D000328:Adult; D001741:Black or African American; D003150:Community Health Workers; D055812:Community-Based Participatory Research; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000208:ethnology* / Q000628:therapy; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D008824:Michigan; D008875:Middle Aged; D010353:Patient Education as Topic; D011203:Poverty; D012648:Self Care; D014505:Urban Population
chemical_list: D006442:Glycated Hemoglobin