Evaluation of a Community Health Worker Pilot Intervention to Improve Diabetes Management in Bangladeshi Immigrants With Type 2 Diabetes in New York City

Abstract

Purpose The purpose of this study is to explore the impact and feasibility of a pilot Community Health Worker (CHW) intervention to improve diabetes management among Bangladeshi-American individuals with Type 2 diabetes living in New York City. Methods Participants were recruited at clinic- and community-based venues. The intervention consisted of six monthly, CHW facilitated group sessions on topics related to management of diabetes. Surveys were collected at baseline and follow-up time points. Study outcomes included clinical, behavioral, and satisfaction measures for participants, as well as qualitative measures from CHWs. Results Improvements were seen in diabetes knowledge, exercise and diet to control diabetes, frequency of checking feet, medication compliance, and self-efficacy of health and physical activity from baseline to 12 months. Additionally, there were decreases in A1C, weight, and BMI. Program evaluation revealed a high acceptability of the intervention, and qualitative findings indicated that CHWs helped overcome barriers and facilitated program outcomes through communal concordance, trust and leadership. Conclusions The intervention demonstrated high acceptability and suggested efficacy in improving diabetes management outcomes among Bangladeshi immigrants in an urban setting. The U.S. Bangladeshi population will continue to increase, and given the high rates of diabetes, as well as linguistic and economic barriers faced by this community, effective and culturally-tailored health interventions are needed to overcome barriers and provide support for diabetes management.

Avaliação da efetividade da promoção da atividade física por agentes comunitários de saúde em visitas domiciliares

“…Corroborando os resultados encontrados no presente estudo, Duggan et al 31 não encontraram diferenças significativas para a mudança no nível de atividade física no lazer em adultos latinos residentes na cidade de Yakima (Washington, Estados Unidos) submetidos a cinco visitas domiciliares temáticas semanalmente, com duração de uma hora, realizadas por ACS após um treinamento de 100 horas. Por outro lado, resultados de estudo realizado com adultos indianos moradores da cidade de Nova Iorque (Estados Unidos), que receberam seis sessões mensais de visitas domiciliares para a promoção de atividade física de promotores de saúde, demonstraram que, após o período de intervenção, a proporção de participantes que referiram praticar atividade física na semana passou de 52% para 89% 15 .…”

“…Nos Estados Unidos, o aumento na prática de atividade física foi encontrado como resultado de estudos de intervenções promovidas por ACS por meio das visitas às populações carentes 14,15 .…”

Defining an Integrative Approach for Health Promotion and Disease Prevention: A Population Health Equity Framework

“…We have seen in our own work the efficacy and effectiveness of CHW interventions in the community. 4,5,7 We are now moving towards better integration and sustainability of CHWs in clinical care teams and care coordination models. 34 For example, through the recently funded NYU-City University of New York Prevention Research Center (NYU-CUNY PRC), we are implementing an integrated CHW-electronic health record intervention to address hypertension management in South Asian populations, working closely with a range of health systems partners, including payer organizations, state and local departments of health, and provider networks, with the ultimate goal of enhancing sustainability and scalability of the CHW model (See Figure 2).…”

Safe and Effective Use of Medicines for Ethnic Minorities - A Pharmacist- Delivered Counseling Program That Improves Adherence

“…Data collection was based on previously validated questionnaires [34,35]. However, most of these had to be adapted to the target group, due to low health literacy, interpretation, and cultural differences.…”