The Role of Community Health Workers in Combating Type 2 Diabetes in the Rio Grande Valley

Abstract

The purpose of this study was to determine the effectiveness of the use of community health workers (CHWs, aka promotoras de salud in Spanish) in the control of type 2 diabetes (diabetes mellitus) in the Rio Grande Valley (RGV). Known from the literature as "a disease of the 21st century" and being the third leading cause of death in the United States, type 2 diabetes is a very common disease in the RGV because of its predominantly Mexican American population, a group genetically vulnerable to the disease. Unlike prior studies that examined the overall effectiveness of the CHW model, the authors used registered CHWs as primary diabetes educators. Another innovation of this study was the authors monitored a wide range of biologic (HbA1c and body mass index [BMI]) and behavioral (diabetes knowledge, self-efficacy, self-management activities scores) outcomes. The research hypothesis was that the educational service provided by CHWs to the diabetic patients would assist them in controlling their disease. The design of the study was experimental. The target population consisted of Mexican American adults from RGV diagnosed with type 2 diabetes and willing to participate. The intervention group received monthly visits from CHWs. The results showed a significant improvement after one year of intervention in all outcomes, except BMI, in the experimental group.

Folic Acid Education for Hispanic Women: The Promotora de Salud Model

“…16 Such programs have been successful in providing important information to sub-segments of the broader population in a culturally-appropriate manner. 17–21 A recent study examined the potential use of the Promotora de Salud model for reaching Hispanic women in North Carolina with the folic acid message, 7 and found it to be a successful model for NTD prevention education and outreach efforts. Building on the North Carolina pilot study, the objective of the current study was to examine the impact of the intervention in three additional counties in the United States.…”

The Effects of a 12 Week Nutrition and Physical Activity Intervention Program on Mexican Americans Residing in the Lower Rio Grande Valley, TX

“…Exposing the participants to information about self-efficacy allowed them to have confidence that they could make and sustain food behavior change. Ryabov and Richardson (2011) also found improvements in diabetes control and weight through the use of self-efficacy.…”

“…The natural helpers in Beyond Sabor emerged as group leaders and were part of the advisory committee discussed in Chapter IV. Studies have successfully used CBPR in underserved communities, such as the Lower Rio Grande Valley, thus further providing the efficacy of this approach (Millard et al, 2013;Ryabov & Richardson, 2011). These interventions have been designed to target both healthier eating behaviors and increase physical activity through engagement and improvement in the target community (Reininger et al, 2014;Perez-Escamilla et al, 2014, Fawcett et al, 2013Wilcox et al, 2013;Balcazar et al, 2010).…”

“…Many of these studies were culturally tailored to Hispanics of varying ages and all were in lower income populations. In addition, the interventions were at least 4 months long with a follow up meeting to weigh the participants (Schwingel et al, 2015;Lindberg et al, 2014;Sorkin et al, 2014) and their effect on FPG and diabetes (Perez-Escamilla et al, 2015;Schwarz, Greaves, Thomas, & Davies, 2014;Yoon, Kwok, & Magkidis, 2013;Ryabov & Richardson, 2011). …”

“…Grande Valley showed improvements in weight, A1c, knowledge of diabetes, and self-efficacy (Sorkin et al, 2014;Ryabov & Richardson, 2011).…”