Mexican American trial of community health workers: a randomized controlled trial of a community health worker intervention for Mexican Americans with type 2 diabetes mellitus.
OBJECTIVE
We assessed whether community health workers (CHWs) could improve glycemic control among Mexican Americans with diabetes.


METHODS
We recruited 144 Mexican Americans with type 2 diabetes between January 2006 and September 2008 into the single-blinded, randomized controlled Mexican American Trial of Community Health Workers (MATCH) and followed them for 2 years. Participants were assigned to either a CHW intervention, delivering self-management training through 36 home visits over 2 years, or a bilingual control newsletter delivering the same information on the same schedule.


RESULTS
Intervention participants showed significantly lower hemoglobin A1c levels than control participants at both year 1 Δ = -0.55; P = .021) and year 2 (Δ = -0.69; P = .005). We observed no effect on blood pressure control, glucose self-monitoring, or adherence to medications or diet. Intervention participants increased physical activity from a mean of 1.63 days per week at baseline to 2.64 days per week after 2 years.


CONCLUSIONS
A self-management intervention delivered by CHWs resulted in sustained improvements in glycemic control over 2 years among Mexican Americans with diabetes. MATCH adds to the growing body of evidence supporting the use of CHWs to reduce diabetes-related health disparities.
Steven K. Rothschild, Molly A. Martin, Imke Janssen, Elizabeth F. Avery, and Lynda H. Powell are with the Department of Preventive Medicine, Rush University Medical Center, and Susan M. Swider is with the Department of Community Systems and Mental Health Nursing, Rush College of Nursing, Chicago, IL. Carmen M. Tumialán Lynas, is a clinical psychologist in independent practice in Oak Brook, IL.
Steven K
SK
Rothschild
Molly A
MA
Martin
Susan M
SM
Swider
Carmen M
CM
Tumialán Lynas
Imke
I
Janssen
Elizabeth F
EF
Avery
Lynda H
LH
Powell
D001794:Blood Pressure; D003153:Community Health Services / Q000379:methods; D003150:Community Health Workers; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology / Q000628:therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D017058:Mexican Americans; D008875:Middle Aged; D010349:Patient Compliance / Q000208:ethnology / Q000706:statistics & numerical data; D012648:Self Care / Q000379:methods; D016037:Single-Blind Method
D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human