University of Michigan, School of Social Work, Ann Arbor, MI 48109-1106, USA.
Am J Public Health. 2011 Dec;101(12):2253-60. doi: 10.2105/AJPH.2010.300106. Epub 2011 Jun 16.
We tested the effectiveness of a culturally tailored, behavioral theory-based community health worker intervention for improving glycemic control.
We used a randomized, 6-month delayed control group design among 164 African American and Latino adult participants recruited from 2 health systems in Detroit, Michigan. Our study was guided by the principles of community-based participatory research. Hemoglobin A1c (HbA1c) level was the primary outcome measure. Using an empowerment-based approach, community health workers provided participants with diabetes self-management education and regular home visits, and accompanied them to a clinic visit during the 6-month intervention period.
Participants in the intervention group had a mean HbA1c value of 8.6% at baseline, which improved to a value of 7.8% at 6 months, for an adjusted change of -0.8 percentage points (P < .01). There was no change in mean HbA1c among the control group (8.5%). Intervention participants also had significantly greater improvements in self-reported diabetes understanding compared with the control group.
This study contributes to the growing evidence for the effectiveness of community health workers and their role in multidisciplinary teams engaged in culturally appropriate health care delivery.
我们检验了一种经文化调适且基于行为理论的社区卫生工作者干预措施在改善血糖控制方面的效果。
我们采用随机、6 个月延迟对照组设计，在密歇根州底特律的 2 家医疗系统中招募了 164 名非裔美国人和拉丁裔成年参与者。我们的研究以社区参与式研究的原则为指导。血红蛋白 A1c（HbA1c）水平是主要的结局衡量指标。社区卫生工作者采用赋权方法为参与者提供糖尿病自我管理教育和定期家访，并在 6 个月的干预期间陪同他们进行一次就诊。
干预组参与者的基线平均 HbA1c 值为 8.6%，在 6 个月时降至 7.8%，调整后变化为-0.8 个百分点（P<.01）。对照组的平均 HbA1c 值没有变化（8.5%）。与对照组相比，干预组参与者在自我报告的糖尿病理解方面也有显著改善。
本研究为社区卫生工作者的有效性提供了更多证据，他们在参与文化适宜的医疗服务提供的多学科团队中发挥着重要作用。
