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

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). 

Methods:  Participants were recruited from clinic-based settings and randomized to 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 four cohorts.  In the treatment group (n=85), recommended physical activity levels increased from 19% to 57% (p<.001), and self-reported knowledge of A1c increased from 13% to 68% (p<.001).  Additionally, significant reductions in mean weight, BMI, and systolic blood pressure were demonstrated (p<0.05).  In the control group (n=74), 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; qualitative findings will be presented to 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 findings are forthcoming.