Effectiveness of a community health worker-led diabetes self-management education program and implications for CHW involvement in care coordination strategies.
OBJECTIVE
The purpose of this study was to evaluate the effectiveness of a Community Health Worker (CHW)-led diabetes self-management education (DSME) program and to understand how CHWs and primary care providers (PCPs) work together to provide comprehensive diabetes care.


METHODS
A quantitative pre- and postassessment of change in patients' blood glucose levels (A1C), blood pressure, and body mass index was performed to determine the clinical effectiveness of the program. Qualitative, semi-structured interviews with 5 CHWs and 7 PCPs were conducted to assess how CHWs were incorporated into clinical teams and their impact on care delivery and diabetes-related outcomes.


RESULTS
Patients who participated in the program experienced a statistically significant decrease in mean A1C levels and systolic blood pressure readings 1 year post baseline. CHWs provided high-quality care and bridged the gap between patients and care providers through diabetes management support and education, medication assistance, access to community resources, and social support.


CONCLUSIONS
CHWs play a variety of roles in helping patients overcome barriers to diabetes control and can be successfully integrated into a health care system's care coordination strategy.
Ashley W. Collinsworth, MPH, ELS, Director of Health Care Research, Baylor Health Care System | Institute for Health Care Research and Improvement, 8080 North Central Expressway, Suite 500, Dallas, TX 75206, USA. Ashley.Collinsworth@baylorhealth.edu.
Ashley W
AW
Collinsworth
Madhulika
M
Vulimiri
Kathryn L
KL
Schmidt
Christine A
CA
Snead
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D003150:Community Health Workers / Q000458:organization & administration / Q000592:standards; D003299:Cooperative Behavior; D003695:Delivery of Health Care; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D015438:Health Behavior; D006266:Health Education / Q000458:organization & administration / Q000592:standards; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D011320:Primary Health Care / Q000458:organization & administration; D015397:Program Evaluation; D011787:Quality of Health Care; D012648:Self Care; D012944:Social Support; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013781:Texas / Q000453:epidemiology; D016903:Drug Monitoring
D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human