A community-based diabetes group pilot incorporating a community health worker and photovoice methodology in an urban primary care practice

Abstract

Objective: The purpose of this study is to evaluate a three-month, community-based, diabetes self-management pilot intervention using photovoice, a community health worker (CHW), and group education sessions in an urban, African-American safety-net population, a group disproportionately affected by diabetes, in order to identify promising diabetes management approaches. Design: We invited patients with poorly-controlled diabetes from diabetes "hotspots" in Boston, located in African-American communities, to participate in six group sessions at a public library. Sessions included photovoice, a methodology whereby patients use photography and written narratives to facilitate deeper reflection about a specified issue. We designed three photovoice missions with different prompts about participants' day-to-day lives related to diabetes. After each mission, a CHW facilitated discussions of participants' experiences, coordinated educational presentations (e.g, dentistry), and connected participants to services. We created an age-and sex-matched control group to compare A1C levels

Acceptability of community health worker and peer supported interventions for ethnic minorities with type 2 diabetes: a qualitative systematic review

“…The PRSIMA diagram describing study selection is shown in Figure 3 ( 47 ). In total the views and perceptions of 387 participants were described, with 15 studies conducted in the USA, one in Canada and another in Australia; of these seven focussed on Latino populations ( 48 – 54 ); five African American ( 55 – 59 ); one mixed of both populations ( 60 ), one Native American ( 61 ), one Punjabi ( 62 ); one Aboriginal ( 63 ); and one on Pacific Islanders ( 64 ). Papers were published between 2009 and 2022.…”

“…Participants described their overall appreciation for the involvement of CHWPs in terms of their communication style and the way in which they made participants feel at ease ( 48 – 53 , 55 , 60 – 65 ). As one African American participant described:…”

Identifying evidence of the effectiveness of photovoice: a systematic review and meta-analysis of the international healthcare literature

“…Online Resource 4 gives an overview of the 28 included studies. There were eighth randomized controlled trials 11 , 12 , 22 , 26 , 29 , 35 , 42 , 44 but the majority pre-post evaluations ( n = 14) 23–25 , 27 , 28 , 30 , 31 , 34 , 38–40 , 43 , 45 , 46 and the remaining non-randomized intervention studies ( n = 3) 33 , 36 , 41 or presenting cross-sectional data ( n = 3). 21 , 32 , 37 Seventeen studies were reported in peer-reviewed academic journals, 11 , 12 , 22 , 24–26 , 28–34 , 37 , 43–45 six postgraduate theses 27 , 35 , 36 , 40–42 and five conference abstracts.…”

“…Online Resource 4 further shows that the large majority of studies were conducted in the USA ( n = 21). 11 , 12 , 22–28 , 30–32 , 34 , 35 , 37–39 , 41–43 , 46 Thirteen studies reported on PV with service users, 11 , 12 , 22 , 23 , 25 , 28 , 30 , 33 , 35 , 38 , 41 , 43 , 46 three with healthcarers. 26 , 34 , 45 Ethnic minority groups were represented in 13 studies.…”

“… 26 , 34 , 45 Ethnic minority groups were represented in 13 studies. 22 , 24 , 25 , 27 , 28 , 30–32 , 35 , 36 , 39 , 41 , 43 Twenty studies were with adults, 11 , 12 , 21 , 22 , 24–26 , 29 , 30 , 32–35 , 38 , 39 , 41–45 seven with children/younger people 23 , 27 , 31 , 36 , 37 , 40 , 46 and one study included both adults and children/younger people. 28 …”