Mexican American Trial of Community Health Workers: A Randomized Controlled Trial of a Community Health Worker Intervention for Mexican Americans With Type 2 Diabetes Mellitus.

TYPE 2 diabetes treatment; CHI-squared test; COMMUNITY health workers; CONFIDENCE intervals; DIABETES; GLYCOSYLATED hemoglobin; HISPANIC Americans; HOME care services; INTERVIEWING; EVALUATION of medical care; METABOLIC regulation; NEWSLETTERS; PATIENT compliance; PATIENT education; PSYCHOLOGICAL tests; QUESTIONNAIRES; RESEARCH funding; HEALTH self-care; STATISTICS; T-test (Statistics); DATA analysis; RANDOMIZED controlled trials; BLIND experiment; DATA analysis software; STATE-Trait Anxiety Inventory; ODDS ratio

Objectives. We assessed whether community health workers (CHWs) could improve glycemic control among Mexican Americans with diabetes. Methods. We recruited 144 Mexican Americans with type 2 diabetes between January 2006 and September 2008 into the single-blinded, randomized controlled Mexican American Trial of Community Health Workers (MATCH) and followed them for 2 years. Participants were assigned to either a CHW intervention, delivering self-management training through 36 home visits over 2 years, or a bilingual control newsletter delivering the same information on the same schedule. Results. Intervention participants showed significantly lower hemoglobin A1c levels than control participants at both year 1 Δ=-0.55; P=.021) and year 2 (Δ =-0.69; P=.005). We observed no effect on blood pressure control, glucose self-monitoring, or adherence to medications or diet. Intervention participants increased physical activity from a mean of 1.63 days per week at baseline to 2.64 days per week after 2 years. Conclusions. A self-management intervention delivered by CHWs resulted in sustained improvements in glycemic control over 2 years among Mexican Americans with diabetes. MATCH adds to the growing body of evidence supporting the use of CHWs to reduce diabetes-related health disparities. [ABSTRACT FROM AUTHOR]

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