A Community Health Worker Intervention for Diabetes Self-Management Among the Tz'utujil Maya of Guatemala. Issue 4 (July 2015)

• Record Type: Journal Article
• Authors: Micikas, Mary; Foster, Jennifer; Weis, Allison; Lopez-Salm, Alyse; Lungelow, Danielle; Mendez, Pedro; Micikas, Ashley
• Is Part Of: Health promotion practice. Volume 16:Issue 4(2015:Jul.)
• Page Start: 601
• Page End: 608
• Publication Date: 2015-07
• Subjects: international/cross-cultural health -- diabetes -- chronic disease -- health education -- health promotion; Health promotion -- Periodicals; Health promotion -- United States -- Periodicals; Health education -- Periodicals; Health education -- United States -- Periodicals; 613
• DOI: 10.1177/1524839914557033
• Languages: English
• ISSNs: 1524-8399

Abstract

Despite the high prevalence of diabetes in rural Guatemala, there is little education in diabetes self-management, particularly among the indigenous population. To address this need, a culturally relevant education intervention for diabetic patients was developed and implemented in two rural communities in Guatemala. An evaluative research project was designed to investigate if the structured, community-led diabetes self-management intervention improved selected health outcomes for participants. A one-group, pretest–posttest design was used to evaluate the effectiveness of the educational intervention by comparing measures of health, knowledge, and behavior in patients pre- and postintervention. A survey instrument assessed health beliefs and practices and hemoglobin A1c (HgA1c) measured blood glucose levels at baseline and 4 months post initiation of intervention (n = 52). There was a significant decrease (1.2%) in the main outcome measure, mean HgA1c from baseline (10.1%) and follow-up (8.9%; p = .001). Other survey findings were not statistically significant. This study illustrates that a culturally specific, diabetes self-management program led by community health workers may reduce HgA1c levels in rural populations of Guatemala. However, as a random sample was not feasible for this study, this finding should be interpreted with caution. Limitations unique to the setting and patient population are discussed in this article.