Objective Examine the effectiveness of using community health workers (CHWs) to support nurse-led diabetes self-management education (DSME) with medically underserved clients.
Methods A pretest-posttest group design was used. A sample of 640 was non-randomly drawn from eastern Kentucky Homeplace division clients who reported that they had been told by a health professional they have type-2 diabetes. The sample size for was reduced to 489 because of a decrease in project funding. Inclusion criteria for the study were Kentucky Homeplace clients 18-65+ years of age who reported they had been told by a provider they have diabetes. Clients meeting inclusion criteria and who signed an IRB were enrolled until the the sample size of 489 was reached. The treatment consisted of nurse-led DSME in 26 Eastern Kentucky Diabetes Belt counties. CHWs and a nurse educator assessed diabetes knowledge, self-empowerment, clinical profile, and self-care on a pre/post test basis. Health literacy was measured using the Ice Cream Label Test and health status using the SF12v2®. DSME tests were from a battery of measures from the University of Michigan Diabetes Research and Training Center. All study instruments had been tested for validity and reliability and had been used in published research.
Results Self-management education improved self-care knowledge and behavior among clients in the treatment group on re-testing after the intervention of DSME. There was improved glucose testing and modest lowering of A1C results as well.
Conclusions CHWs were effective in providing support for DSME. The CHWs succeeded in screening clients, obtaining their IRB consent, and enrolling them in the study. They also successfully administered study instruments, provided follow-up assistance to clients regarding the DSME, and entered data in the Homeplace database.
This research was supported by a gift from Wellpoint Foundation/Anthem.
Kegley, Janet; Collett, Helen; and Fugate, Ralph, "Role of Community Health Workers in Improving Diabetes Outcomes" (2012). Center of Excellence in Rural Health Presentations. 7.