Islam Nadia S, Wyatt Laura C, Patel Shilpa D, Shapiro Ephraim, Tandon S Darius, Mukherji B Runi, Tanner Michael, Rey Mariano J, Trinh-Shevrin Chau
Center for the Study of Asian American Health, NYU School of Medicine, New York, New York (Dr Islam, Ms Wyatt, Ms Patel, Dr Shapiro, Dr Rey, Dr Trinh-Shevrin)
Department of Medicine, Division of General Internal Medicine, NYU School of Medicine, New York, New York (Dr Islam, Dr Tanner, Dr Trinh-Shevrin)
Diabetes Educ. 2013 Jul-Aug;39(4):478-93. doi: 10.1177/0145721713491438. Epub 2013 Jun 7.
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.
Participants were recruited at clinic- and community-based venues. The intervention consisted of 6 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.
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 body mass index. 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.
The intervention demonstrated high acceptability and suggested efficacy in improving diabetes management outcomes among Bangladeshi immigrants in an urban setting. The US 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.
本研究旨在探讨一项试点社区卫生工作者（CHW）干预措施对改善居住在纽约市的患有2型糖尿病的孟加拉裔美国人糖尿病管理的影响及可行性。
在诊所和社区场所招募参与者。干预措施包括由社区卫生工作者主持的6次月度小组会议，主题涉及糖尿病管理。在基线和随访时间点收集调查问卷。研究结果包括参与者的临床、行为和满意度指标，以及社区卫生工作者的定性指标。
从基线到12个月，参与者在糖尿病知识、控制糖尿病的运动和饮食、检查足部频率、药物依从性以及健康和身体活动自我效能方面均有改善。此外，糖化血红蛋白、体重和体重指数有所下降。项目评估显示该干预措施具有较高的可接受性，定性研究结果表明社区卫生工作者通过社区和谐、信任和领导力帮助克服障碍并促进了项目成果。
该干预措施显示出较高的可接受性，并在改善城市环境中孟加拉裔移民的糖尿病管理结果方面显示出疗效。美国的孟加拉裔人口将持续增加，鉴于该社区糖尿病发病率高，以及面临的语言和经济障碍，需要有效的、符合文化特点的健康干预措施来克服障碍并为糖尿病管理提供支持。
