title: The Mexican-American Trial of Community Health workers (MATCH): design and baseline characteristics of a randomized controlled trial testing a culturally tailored community diabetes self-management intervention.
abstract: OBJECTIVE
  Community Health Workers (CHWs) have been recommended to reduce diabetes disparities, but few robust trials of this approach have been conducted. Limitations of prior studies include: unspecified a priori outcomes; lack of blinded outcome assessments; high participant attrition rates; and lack of attention to intervention fidelity. These limitations reflect challenges in balancing methodologic rigor with the needs of vulnerable populations. The Mexican-American Trial of Community Health workers (MATCH) was a blinded randomized controlled trial testing CHW efficacy in improving physiologic outcomes and self-management behaviors among Mexican-Americans with type 2 diabetes. This paper describes methods used to overcome limitations of prior studies.
  
  
  METHODS
  The primary aim was to determine if a CHW intervention would result in significant reductions in Hemoglobin A1c and rates of uncontrolled blood pressure. 144 Mexican-Americans with diabetes were randomized. The intervention consisted of self-management training delivered by CHWs over a 24-month period; the comparison population received identical information via bilingual newsletter. Blinded research assistants completed assessments at baseline, 12 months, and 24 months post-randomization.
  
  
  RESULTS
  The MATCH cohort was characterized by low acculturation and socioeconomic status. Study participants had low rates of medication adherence and glucose monitoring. 70% had poor glycemic control with A1c levels over 7.0, and 57.3% had blood pressures worse than ADA target levels (<130/80).
  
  
  CONCLUSIONS
  MATCH preserved community sensitivity and methodologic rigor. The study's attention to intervention fidelity, behavioral attention control, blinded outcomes assessment, and strategies to enhance participant retention can be replicated by researchers testing culturally-tailored CHW interventions.
authors: Department of Preventive Medicine, Rush University Medical Center, 1700 W. Van Buren, Suite 470, Chicago, IL 60612, USA. Steven_K_Rothschild@rush.edu
authors: Steven K
authors: SK
authors: Rothschild
authors: Molly A
authors: MA
authors: Martin
authors: Susan M
authors: SM
authors: Swider
authors: Carmen T
authors: CT
authors: Lynas
authors: Elizabeth F
authors: EF
authors: Avery
authors: Imke
authors: I
authors: Janssen
authors: Lynda H
authors: LH
authors: Powell
mesh_terms: D002641:Chicago / Q000453:epidemiology; D003150:Community Health Workers; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000208:ethnology / Q000628:therapy*; D019468:Disease Management; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000378:metabolism; D054624:Health Status Disparities; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D017058:Mexican Americans; D008875:Middle Aged; D010349:Patient Compliance; D015995:Prevalence; D011446:Prospective Studies; D012648:Self Care / Q000379:methods*; D016037:Single-Blind Method; D016896:Treatment Outcome
chemical_list: D006442:Glycated Hemoglobin