248373 CHWs as Standard Therapy for Diabetes? Implications of the Results from the Mexican-American Trial of Community Health Workers (MATCH)

Wednesday, November 2, 2011: 8:30 AM

Molly A. Martin, MD , Department of Preventive Medicine, Rush University Medical Center, Chicago, IL
Steven Rothschild, MD , Departments of Family Medicine and Preventive Medicine, Rush University Medical Center, Chicago, IL
Susan M. Swider, PhD, APHN-BC , College of Nursing, Rush University Medical Center, Chicago, IL
Carmen Tumialan Lynas, PhD , Department of Preventive Medicine, Rush University Medical Center, Chicago, IL
Imke Janssen, PhD , Department of Preventive Medicine, Rush University Medical Center, Chicago, IL
Community health workers (CHWs) have gained popularity as a vehicle for accessing underserved communities and for involving communities in health initiatives. Their main activities are to provide health education, information, assistance with services, and build individual and community capacity for health. However, rigorous research studies--like those used to approve diabetes medications--on the effectiveness of CHW interventions are lacking, and this limits the ability to fully integrate CHWs into the health care delivery system.

The MATCH trial (Mexican-American Trial of Community Health Workers) was designed to test the hypothesis that CHWs, recruited from the community and trained to provide culturally appropriate diabetes education in the home, can promote pro-active self-management among urban Mexican-Americans with Type2 diabetes mellitus. This randomized controlled trial of 144 adults was recently completed, and results indicated a significant reduction in hemoglobin A1c in participants receiving a CHW intervention, compared to those receiving an attention control. This reduction was sustained over two years. No adverse effects were documented, and full costs of the CHW intervention were lower than most newly introduced diabetes medications.

The MATCH trial used the methodologic rigor and blinded assessments required for approval of new medical therapies. This trial provides strong evidence that CHW interventions are an effective, safe therapy for diabetes management. Implications of these results for medical and public health practice, including costs, resource needs and long-term benefits to overall patient health will be discussed. We will also discuss needs for additional research and moving research into policy.

Learning Areas:
Chronic disease management and prevention
Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Public health or related public policy

Learning Objectives:
List the primary findings of the Mexican American Trial of Community Health workers, describe three implications of expansion of the CHW role in the treatment of diabetes in community settings

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the principal investigator for the MATCH trial and oversaw the design, implementation, and conduct of the study.
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.