Latino Health Access: Comparative Effectiveness of a Community-Initiated Promotor/a-Led Diabetes Self-management Education Program. Issue 1 (January 2022)

• Record Type: Journal Article
• Authors: Slater, Allison; Cantero, Patricia J.; Alvarez, Guillermo; Cervantes, Brett S.; Bracho, America; Billimek, John
• Is Part Of: Family & community health. Volume 45:Issue 1(2022)
• Publication Date: 2022-01
• Subjects: community health centers -- community health education -- community health workers -- diabetes mellitus -- Hispanic Americans -- Latinx -- promotores -- type 2; Preventive health services -- Periodicals; Community health services -- Periodicals; Family medicine -- Periodicals; 362.1
• DOI: 10.1097/FCH.0000000000000311
• Languages: English
• ISSNs: 0160-6379

Abstract

Abstract : Community-initiated health interventions fill important gaps in access to health services. This study examines the effectiveness of a community-initiated health intervention to improve diabetes management in an underserved community of color using a retrospective observational study, comparing a study intervention, the Latino Health Access Diabetes Self-Management Program (LHA-DSMP), with usual care. The LHA-DSMP is a 12-session community health worker ( promotor/a ) intervention developed and implemented by a community-based organization in a medically underserved area. Usual care was delivered at a federally qualified health center in the same geographic area. Participants were 688 predominantly Spanish-speaking Latinx adults with type 2 diabetes. The main outcome was change in glycemic control (glycosylated hemoglobin [HbA1c ]) from baseline to follow-up. At 14-week follow-up, mean (95% CI) HbA1c decrease was −1.1 (−1.3 to −0.9; P < .001) in the LHA-DSMP cohort compared with −0.3 (−0.4 to −0.2; P < .001) in the comparison cohort. Controlling for baseline differences between cohorts, the adjusted difference-in-differences value in HbA1c was −0.6 (−0.8 to −0.3; P < .001) favoring the LHA-DSMP. A community-initiated promotor/a -led educational program for diabetes self-management is associated with clinically significant improvement in blood sugar control, superior to what was observed with usual medical care.