Hill Jillian, Peer Nasheeta, Oldenburg Brian, Kengne Andre Pascale
Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa.
Department of Medicine, University of Cape Town, Cape Town, South Africa.
PLoS One. 2017 Dec 7;12(12):e0189069. doi: 10.1371/journal.pone.0189069. eCollection 2017.
To examine the characteristics of community health workers (CHWs) involved in diabetes prevention programmes (DPPs) and their contributions to expected outcomes.
Electronic databases including PubMed-MEDLINE, EBSCOHost, and SCOPUS/EMBASE were searched for studies published between January 2000 and March 2016. All studies that used CHWs to implement DPP in ≥18-year-old participants without diabetes but at high risk for developing the condition, irrespective of the study design, setting or outcomes measured, were included. Results were synthesized narratively.
Forty papers of 30 studies were identified. Studies were mainly community-based and conducted in minority populations in USA. Sample sizes ranged from 20 participants in a single community to 2369 participants in 46 communities. Although CHWs were generally from the local community, their qualifications, work experience and training received differed across studies. Overall the training was culturally sensitive and/or appropriate, covering topics such as the importance of good nutrition and the benefits of increased physical activity, communication and leadership. CHWs delivered a variety of interventions and also screened or recruited participants. The shared culture and language between CHWs and participants likely contributed to better programme implementation and successful outcomes.
The complexity of DPPs and the diverse CHW roles preclude attributing specific outcomes to CHW involvement. Nevertheless, documenting potential CHW roles and the relevant training required may optimise CHW contributions and facilitate their involvement in DPPs in the future.
研究参与糖尿病预防项目（DPPs）的社区卫生工作者（CHWs）的特征及其对预期结果的贡献。
检索电子数据库，包括PubMed-MEDLINE、EBSCOHost和SCOPUS/EMBASE，查找2000年1月至2016年3月发表的研究。纳入所有使用社区卫生工作者在≥18岁无糖尿病但患糖尿病风险高的参与者中实施糖尿病预防项目的研究，无论研究设计、环境或测量的结果如何。结果进行叙述性综合。
确定了30项研究的40篇论文。研究主要基于社区，在美国少数民族人群中开展。样本量从单个社区的20名参与者到46个社区的2369名参与者不等。虽然社区卫生工作者一般来自当地社区，但不同研究中他们的资质、工作经验和接受的培训有所不同。总体而言，培训具有文化敏感性和/或适当性，涵盖良好营养的重要性、增加体育活动的益处、沟通和领导力等主题。社区卫生工作者提供了各种干预措施，还对参与者进行筛查或招募。社区卫生工作者与参与者之间共有的文化和语言可能有助于更好地实施项目并取得成功结果。
糖尿病预防项目的复杂性和社区卫生工作者角色的多样性使得无法将特定结果归因于社区卫生工作者的参与。然而，记录社区卫生工作者的潜在角色和所需的相关培训可能会优化社区卫生工作者的贡献，并便于他们未来参与糖尿病预防项目。
