173085 Outcomes from a Randomized Community Health Worker Intervention for African Americans and Latinos with Diabetes in Detroit

Tuesday, October 28, 2008: 3:20 PM

Michael Spencer, PhD , School of Social Work, University of Michigan, Ann Arbor, MI
Ann-Marie Rosland, MD , Clinical Scholars Program, University of Michigan Medical School, Ann Arbor, MI
Brandy Sinco, MS , School of Social Work, University of Michigan, Ann Arbor, MI
Edith Kieffer, PhD , School of Social Work, University of Michigan, Ann Arbor, MI
Gloria Palmisano, BS, MA , REACH-Detroit Partnership, Detroit, MI
Michael Anderson , REACH-Detroit Partnership, Detroit, MI
Michele Heisler, MD, MPA , Division of General Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI
     
Objective. Assess changes in blood sugar, cholesterol, knowledge, and self management care among African American and Latino participants in the REACH Detroit Family intervention.

Methods. 164 Latino and African American persons with type 2 diabetes participated in a culturally tailored diabetes education program led by trained community health workers. Participants were randomized to receive the intervention immediately (intervention group) or after 6 months (control group). Through surveys and lab results, we assessed changes between baseline and 6 month follow-up measures of hemoglobin A1c, cholesterol, fruit and vegetable consumption, physical activity, and knowledge of diabetes management. Repeated measures models were used to measure change and to identify correlates of change.

Results. Among 130 participants who completed baseline and 6 month assessments, Hemoglobin A1c dropped by an average of 0.8% in the intervention group and by 0.4% in the control group. Average LDL cholesterol dropped by 10.1 mg/dL in the intervention group and by 6.7 mg/dL in the control group. These drops in A1c and LDL cholesterol were statistically significant (p < 0.05) within the immediate arm, but not between the delayed and immediate arms. Physical activity improved in both the immediate and delayed intervention arms. Both intervention groups increased average daily fruit and vegetable consumption by 0.5 servings/day. Knowledge of the relationships between physical activity, diet, and blood sugar improved for the intervention group, relative to the control group (p <0.05).

Conclusion. A randomized, community-based, culturally tailored community health worker intervention can significantly improve diabetes risk factors and outcomes.

Learning Objectives:
Participants will be able to: 1) Identify and describe significant outcomes among intervention participants. 2) Discuss issues associated with conducting a community-based, participatory culturally tailored health intervention with a randomized design. 3) Discuss implications of methods and results for future community-based interventions aimed at reducing health disparities.

Keywords: Diabetes, Community Health Advisor

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the Team Leader of the Family Intervention and Co-I of the REACH Detroit Partnership, hold a PhD, and am an Assosiate Professor at the University of Michigan.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Health Disparities
See more of: Epidemiology