Steven K. Rothschild, Molly A. Martin, Imke Janssen, Elizabeth F. Avery, and Lynda H. Powell are with the Department of Preventive Medicine, Rush University Medical Center, and Susan M. Swider is with the Department of Community Systems and Mental Health Nursing, Rush College of Nursing, Chicago, IL. Carmen M. Tumialán Lynas, is a clinical psychologist in independent practice in Oak Brook, IL.
Am J Public Health. 2014 Aug;104(8):1540-8. doi: 10.2105/AJPH.2013.301439. Epub 2013 Aug 15.
We assessed whether community health workers (CHWs) could improve glycemic control among Mexican Americans with diabetes.
We recruited 144 Mexican Americans with type 2 diabetes between January 2006 and September 2008 into the single-blinded, randomized controlled Mexican American Trial of Community Health Workers (MATCH) and followed them for 2 years. Participants were assigned to either a CHW intervention, delivering self-management training through 36 home visits over 2 years, or a bilingual control newsletter delivering the same information on the same schedule.
Intervention participants showed significantly lower hemoglobin A1c levels than control participants at both year 1 Δ = -0.55; P = .021) and year 2 (Δ = -0.69; P = .005). We observed no effect on blood pressure control, glucose self-monitoring, or adherence to medications or diet. Intervention participants increased physical activity from a mean of 1.63 days per week at baseline to 2.64 days per week after 2 years.
A self-management intervention delivered by CHWs resulted in sustained improvements in glycemic control over 2 years among Mexican Americans with diabetes. MATCH adds to the growing body of evidence supporting the use of CHWs to reduce diabetes-related health disparities.
我们评估了社区卫生工作者（CHW）是否能够改善墨西哥裔美国糖尿病患者的血糖控制。
我们于 2006 年 1 月至 2008 年 9 月招募了 144 名患有 2 型糖尿病的墨西哥裔美国人，参与单盲、随机对照的墨西哥裔美国社区卫生工作者试验（MATCH），并对他们进行了 2 年的随访。参与者被分配到 CHW 干预组，通过 36 次家访在 2 年内提供自我管理培训，或分配到双语对照组，以相同的时间表提供相同的信息。
干预组参与者的血红蛋白 A1c 水平在第 1 年（Δ=-0.55；P=.021）和第 2 年（Δ=-0.69；P=.005）均显著低于对照组参与者。我们没有观察到对血压控制、血糖自我监测、药物或饮食依从性的影响。干预组参与者的身体活动从基线时的每周 1.63 天增加到 2 年后的每周 2.64 天。
由 CHW 提供的自我管理干预在 2 年内持续改善了墨西哥裔美国糖尿病患者的血糖控制。MATCH 增加了越来越多的证据，支持使用 CHW 来减少与糖尿病相关的健康差异。
