A peer cunseling best practices model for diabetes management support among Latinos: The DIALBEST trial

A case-control study evaluating the health status of Latinos with type-2 diabetes in the Hartford area revealed alarming diabetes-related health problems associated with poor glycemic control, obesity, low health care services utilization, food insecurity, and poor nutrition and diabetes knowledge. In light of these findings, a randomized longitudinal intervention was designed to evaluate the efficacy of a culturally-tailored, community-based peer counseling (PC) model designed to provide home-based support and promote diabetes self-management as a supplement to the standard of care “Amigos en Salud” health care program at Hartford Hospital (HH). The PC service was carefully developed prior to launching the intervention. The Hispanic Health Council-based peer counselors were extensively trained in areas including health disparities, type-2 diabetes and its management, nutrition, and communication skills. Thereafter type-2 diabetes participants of the “Amigos en Salud” program are being recruited. Participants are randomly assigned to either the standard of care or additional PC. The PC program consists of 4 weekly home visits during the first month, 4 biweekly visits during months two and three, and nine additional monthly visits. The baseline characteristics of the initial pool of participants (15 females, 5 males; ages 34-68 y) indicate a high prevalence of obesity (BMI=36.6±6.1 kg/m²; range 29.1–49.8 kg/m²) and poor glycemic control (HbA1c=10.2±1.9%; median=9.7%, range 7.5–13%). These preliminary findings indicate that the population being targeted can benefit substantially from the PC intervention. Funded by the Connecticut NIH EXPORT Center of Excellence for Eliminating Health Disparities among Latinos (NIH-NCMHD grant #P20MD001765).