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Community health workers help type 2 diabetes care
Date:2/11/2013

The workers would test and explain blood glucose readings, remind patients to keep up with medicines and doctors' clinic visits, and lead educational discussions about diet and exercise based on educational materials developed by the research team. If patients were having problems caring for themselves, the workers were trained to help them solve the problems.

Patients could choose from a menu of eight topics for their educational discussions.

The basic model for the intervention came from the successful "Project Sugar 2" trial in Baltimore, but study lead author Judith DePue of The Miriam and Brown said she and her team made many cultural adaptations after conducting extensive ethnographic research, including focus groups with patients.

The educational materials were in both English and Samoan. The foods and activities represented in the text and visuals were familiar and accessible in the territory's culture. All the community health workers were local residents, and the community health worker visits were free of charge (DePue's research found that even small co-pays were deterring some of the territory's residents from seeking primary care).

"We really needed to make it work in this setting," DePue said. "The adaptation that we did, we think, was part of why it was successful."

The study's main measure of that success was a blood glucose level called HbA1c. At the beginning of the study the average level in the intervention group was 9.6 percent and in the traditional care group was 10 percent. After a year, the intervention group members brought levels down to 9.3 percent on average, while among the traditional care group the average level remained at 10 percent.

Meanwhile, more than 42 percent of patients in the intervention group were able to reduce their HbA1c level by more than half a percentage point, a reduction that diabetes researchers consider clinically significant.

The researchers acknow
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Contact: David Orenstein
david_orenstein@brown.edu
401-863-1862
Brown University
Source:Eurekalert  

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