2015 APHA Annual Meeting & Expo

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Recorded Annual Meeting Presentations (RAMP) are now available for purchase.
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Online Program

318330
Clinical and Psychosocial Outcomes from a Randomized Community Health Worker, Federally Qualified Center-Based Intervention for Latinos with Diabetes


Tuesday, November 3, 2015 : 2:30 p.m. - 2:50 p.m.

Michael Spencer, PhD, School of Social Work, University of Michigan, Ann Arbor, MI
Edith Kieffer, MPH, PhD, School of Social Work, University of Michigan, Ann Arbor, MI
Brandy Sinco, MS, School of Social Work, University of Michigan, Ann Arbor, MI
Gloria Palmisano, BS, MA, REACH Detroit Partnership, Community Health & Social Services Center, Inc., Detroit, MI, MI
Michael Anderson, CHASS, Detroit, MI
Emily Nicklett, PhD, MSW, School of Social Work, University of Michigan, ann arbor, MI
Gretchen Piatt, PhD, MPH, Department of Medical Education, University of Michigan, Ann Arbor, MI
Nicolaus Espitia, MSW, School of Social Work, University of Michigan, Ann Arbor, MI
Alana M.W. LeBron, PhD, MS, University of Michigan National Center for Institutional Diversity, Ann Arbor, MI
Jaclynn Hawkins, MSW, School of Social Work, University of Michigan, Ann Arbor, MI
Ann-Marie Rosland, MD, MS, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI
Michele Heisler, MD MPA, Department of Internal Medicine, University of Michigan, Ann Arbor, MI
Audio (mp3) recording Recorded Presentation (mp4)
Objective.  To assess changes in clinical and psychosocial diabetes outcomes over six months among participants in the community health worker (CHW)-led REACH Detroit diabetes intervention for Latinos, compared to an EUC (enhanced usual care) group.

Methods. Latinos (n=222) with type 2 diabetes participated in the study.  The intervention group received a culturally tailored 11-session healthy lifestyle and diabetes self-management curriculum taught by trained CHWs, who also accompanied participants to at least one clinic visit and conducted a home visit. The EUC group received one class on understanding diabetes-related clinical values taught by a research assistant, and information about community resources. Our primary outcome was change in HbA1c. We also assessed changes between baseline and 6-month follow-up in cholesterol, blood pressure, waist circumference, diabetes distress, diabetes support, understanding diabetes self-management and depressive symptoms.  Repeated measures models were used to evaluate change from baseline to 6 months within and between groups.

 Results.   Among 184 participants who completed baseline and 6 month assessments, mean hemoglobin HbA1c decreased 0.5% in the intervention group, compared to 0.0% in the EUC group, p<.05 between groups.  Relative to the EUC group, the intervention group had significant improvements in diabetes distress (p<.04), diabetes social support (p=.005), and understanding diabetes self-management (p<.04).  Although the intervention group had significant improvements in systolic and diastolic blood pressure, waist and hip circumference and depression, between group improvements in these outcomes were insignificant.

Conclusion. A culturally tailored CHW intervention significantly improved glycemic control and diabetes-related psychosocial outcomes among Latinos with type 2 diabetes.

Learning Areas:

Administer health education strategies, interventions and programs
Biostatistics, economics
Chronic disease management and prevention
Diversity and culture
Public health or related research
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Identify and describe significant outcomes among intervention and enhanced usual care participants. Discuss the design and methods of the REACH Detroit diabetes intervention for Latinos Discuss implications of methods and results for future community-based interventions aimed at reducing health disparities.

Keyword(s): Latinos, Diabetes

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a professor at the UM School of Social Work and have been involved in health disparities interventions for many years. I am an author of many peer reviewed articles.
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.

Back to: 4333.0: Oral: Latino mental health