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Diabetes Community Outreach Project: Community Health Worker Intervention to Improve Diabetes Screening, Education and Care in Rural India
The SEVAK Diabetes Community Outreach Project, a 3 year community-based, statewide educational intervention, evaluated whether a community health worker (CHW) intervention can improve screening and thus influence clinically relevant markers of diabetes care in adult rural Indians. Trained Community Health Workers [termed SEVAKs] screened participants for diabetes, hypertension and obesity and provided educational intervention.
Research Design and Methods
26 SEVAKS, 4 Regional Coordinators, and 1 Project Coordinator were trained for 4 weeks at the Baroda Medical Center by an interdisciplinary team. Targeted participants were adult Indians in all 26 counties in state of Gujarat India [one village/county], ages 18–80 years. The primary outcomes were identifying individuals with pre-diabetes and undiagnosed diabetes and high blood pressure.
Results
SEVAKs were highly effective in recruiting participants in rural areas: > 95% response rate. This success may be due to their acceptance as members of their villages and trust in the confidentiality of information. Screening was completed for 23,612 participants [48.4% females and 51.5% males] in the past 3 years. Prevalence of diabetes, pre-diabetes and hypertension was 3.8, 3.8, and 10.5% respectively. One-fifth of the participants smoked or chewed tobacco. Follow-up visit was made to individuals with abnormal blood sugar and blood pressure (n=19,867), and one-on-one educational intervention and/or referrals to providers were made when educational intervention was inadequate.
Conclusions
Continuous training and adequate supervision improved screening, diagnosis and care by the CHW intervention. It is a successful model for socioeconomically disadvantaged populations.
Learning Areas:
Chronic disease management and preventionPublic health or related education
Learning Objectives:
Describe the program.
List the prevalence of chronic diabetes and hypertension in the state.
Discuss the impact of the community-based education program.
Keyword(s): Community Health Workers and Promoters, Community Health Assessment
Qualified on the content I am responsible for because: I am a health disparities researcher with programs in Mexico, India, and the US. I have been doing community based programs for the past 10 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.