Improving Retention and Data Collection Rates for a Community Health Worker Intervention to Improve Diabetes Management and Control among Bangladeshis in New York City

Background: The effective implementation of community-based health interventions can be impeded by myriad factors. Ongoing process and pilot evaluations can help to identify these factors, so that programs can make strategic improvements to minimize attrition and improve study implementation. In 2010, we completed a pilot study of a six-month community health worker intervention (CHW) designed to improve management and control among Bangladeshi diabetics in New York City. Objective: Upon the completion of the pilot, extensive program evaluation was performed to identify ways to decrease attrition, improve retention, and improve data collection rates for survey questionnaires and clinical measurements. Methods: Evaluation tools included attendance sheets, program satisfaction questionnaires, and input from CHWs, project staff, and a community coalition. Results: Based on the aforementioned program evaluation, several important changes were made to the intervention, including (but not limited to) adjusting the intervention protocol and delivery methods, centralizing recruitment to a clinic-based source (rather than community-based recruitment), as well as screening for future travel to the home country prior to study enrollment. The above changes were implemented in the first round of the full intervention, which was undertaken in 2011. As a result, completion-on-intervention rates were improved from 67% to 89%, and data collection rates at the 6-month timepoint were increased from 33% to 91%. Conclusions: The above findings suggest that retention and data collection rates in a community-based health intervention for diabetes can be improved through meaningful program evaluation, which can greatly enhance study implementation and validity.