142nd APHA Annual Meeting and Exposition

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302052
Mixed-Methods Evaluation of a Randomized Control-Trial Community Health Worker Intervention to Improve Diabetes Management in the New York City Bangladeshi Community

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014

Lindsey Riley, MPH , Department of Population Health, New York University School of Medicine, New York, NY
Gulnahar Alam , Center for the Study of Asian American Health, NYU Institute of Community Health and Research, NYU School of Medicine, New York, NY
Mamnunul Haq , Department of Population Health, NYU School of Medicine, New York, NY
MD Taher , Department of Population Health, NYU School of Medicine, New York, NY
Laura Wyatt, MPH , Center for the Study of Asian American Health, NYU School of Medicine, New York, NY
S. Darius Tandon, PhD , Feinberg School of Medicine, Northwestern University, New York, NY
Michael Tanner, MD , Center for the Study of Asian American Health, NYU Institute of Community Health and Research, DREAM Project Coalition, New York, NY
Purnima Naik, MD , NYU School of Medicine, Center for the Study of Asian American Health, NYU Institute of Community Health and Research, DREAM Project Coalition, New York, NY
Shahnaz Yousuf , NYU School of Medicine, Center for the Study of Asian American Health, NYU Institute of Community Health and Research, DREAM Project Coalition, New York, NY
Runi Mukherji-Ratnam, PhD , NYU School of Medicine, Center for the Study of Asian American Health, NYU Institute of Community Health and Research, DREAM Project Coalition, New York, NY
Mariano Rey, MD , Center for the Study of Asian American Health, Institute of Community Health and Research, NYU School of Medicine, New York, NY
Chau Trinh-Shevrin, DPH , Department of Population Health, NYU School of Medicine, New York, NY
Nadia Islam, PhD , Center for the Study of Asian American Health, NYU Institute of Community Health and Research, NYU School of Medicine, New York, NY
Background:  High rates of diabetes among Bangladeshi immigrants in the U.S. and U.K. have been documented. However, few culturally- and linguistically-tailored health interventions have been implemented in this community.   Findings are reported from a CDC- & NIH-funded Community Health Worker (CHW) intervention designed to improve diabetic management among Bangladeshis in New York City (NYC). 

Purpose:  To describe and present mixed-methods results from a diabetes management intervention adapted for the Bangladeshi community.

Methods:  Participants were recruited from clinic-based settings and randomized to either treatment or control group.  Treatment participants received 5 group educational seminars and 2 one-on-one visits from a CHW over a 6-month period.  Control participants received an introductory seminar only.

Results:  Preliminary results include changes from baseline to 6-months for three cohorts.  In the treatment group (n=73), recommended physical activity levels increased from 32% to 92% (p<.001), and self-reported knowledge of A1c increased from 11% to 67% (p<.001).  Additionally, significant reductions in mean weight, BMI, and systolic blood pressure were demonstrated (p<0.05).  In the control group (n=54), no significant changes were demonstrated in the areas of physical activity, nutritional behaviors, or clinical measures between baseline and follow-up.  Retention rates were high; 70% of participants completed the full intervention (8% lost to follow-up).  Final analysis will include quantitative data on five cohorts, as well as qualitative data obtained through CHW case notes.  Qualitative findings will be used to help illuminate specific mechanisms through which CHWs operate to impact behavior change.

Conclusions:   Significant improvements were demonstrated in the treatment group in several areas relevant to diabetes control. Findings suggest that a CHW intervention in this community can be effective.   Results from an additional study cohort, as well as qualitative analysis of CHW case notes are forthcoming.

Learning Areas:

Administer health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Public health or related research

Learning Objectives:
Evaluate mixed-method findings from a CHW intervention adapted for use in the Bangladeshi community Describe how to implement a CHW intervention designed to improve diabetic control and management

Keyword(s): Community Health Workers and Promoters, Asian Americans

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been responsible for the day-to-day oversight of this study for the past three years, and as such, am intimately familiar with the study design, implementation, reporting, and analysis. Additionally, I have coordinated numerous state- and federally-funded grants, as well as industry-sponsored clinical trials in the past seven years.
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.