Community Health Workers Versus Nurses as Counselors or Case Managers in a Self-Help Diabetes Management Program

Am J Public Health. 2016 Jun;106(6):1052-8. doi: 10.2105/AJPH.2016.303054. Epub 2016 Mar 17.

Abstract

Objectives: To confirm the effectiveness of community health workers' involvement as counselors or case managers in a self-help diabetes management program in 2009 to 2014.

Methods: Our open-label, randomized controlled trial determined the effectiveness of a self-help intervention among Korean Americans aged 35 to 80 years in the Baltimore-Washington metropolitan area with uncontrolled type 2 diabetes. We measured and analyzed physiological and psychobehavioral health outcomes of the community health worker-counseled (n = 54) and registered nurse (RN)-counseled (n = 51) intervention groups in comparison with the control group (n = 104).

Results: The community health workers' performance was comparable to that of the RNs for both psychobehavioral outcomes (e.g., self-efficacy, quality of life) and physiological outcomes. The community health worker-counseled group showed hemoglobin A1C reductions from baseline (-1.2%, -1.5%, -1.3%, and -1.6%, at months 3, 6, 9, and 12, respectively), all of which were greater than reductions in the RN-counseled (-0.7%, -0.9%, -0.9%, and -1.0%) or the control (-0.5%, -0.5%, -0.6%, and -0.7%) groups.

Conclusions: Community health workers performed as well as or better than nurses as counselors or case managers in a self-help diabetes management program in a Korean American community.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Asian
  • Baltimore
  • Blood Glucose / analysis
  • Case Managers
  • Community Health Workers*
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / psychology*
  • Disease Management*
  • Glycated Hemoglobin / analysis
  • Humans
  • Middle Aged
  • Nurses*
  • Self Care / methods*

Substances

  • Blood Glucose
  • Glycated Hemoglobin A