JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China.
Center for Health Systems and Policy Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China.
Front Public Health. 2022 Oct 10;10:957754. doi: 10.3389/fpubh.2022.957754. eCollection 2022.
Lay health workers, despite their lack of formal trainings, are important partners in providing accessible care to people with risk to develop diabetes in the community. While pre-diabetes and diabetes are more prevalent among people with low socio-economic status, including those living in inadequate houses. However, this population often have accessibility problems to formal care services due to their financial and social disadvantages. In a high-income, developed Chinese society, this pragmatic randomized controlled trial seeks to investigate the effect of a 6-months lay health worker intervention in diabetes management among people living in sub-divided flats units in Hong Kong.
In this trial, 222 Chinese primary caregivers living in inadequate houses and with diabetes risk will be recruited non-profit organizations serving in districts with low average household incomes and prevalent subdivided flats in Hong Kong. Adopting a 6 months wait-list control, participants will be randomized to receive a 6-months lay health worker intervention of 5 components, including (1) lay health worker training and support; (2) health professional training; (3) formulation of a targeted care plan for the health and nutritional needs of the families; (4) case management approach; and (5) financial subsidy for lay health workers to sustain the practice. The control group will receive usual care and health information on diabetes risk management. Glycated hemoglobin (HbA1c) and fasting blood glucose will be taken at the entry and exit assessment of this trial as primary outcomes.
Our randomized controlled trial is one of the first to investigate the effect of lay health worker intervention on pre-diabetes management in a low-income Chinese population residing in inadequate houses. This study could provide insights to consider alternative service provision models to people living with diabetes risk in the community, by providing a care option to be supported by community health workers and enhanced community participation of care providers. This study attempts to evaluate the impact of a lay health worker intervention using a mixed-method study design. Despite its contribution, this study might be subjected to sampling bias since all the participants will be recruited from non-profit organizations serving deprived populations.
ChiCTR2100052080 in Chinese Clinical Trial Registry. URL: https://www.chictr.org.cn/edit.aspx?pid=134928&htm=4.
尽管非专业卫生工作者缺乏正规培训，但他们仍是向社区中有可能患上糖尿病的人群提供可及性护理的重要合作伙伴。在社会经济地位较低的人群中，包括居住在住房条件较差的人群中，前驱糖尿病和糖尿病更为普遍。然而，由于经济和社会劣势，这些人群往往难以获得正规医疗服务。在一个高收入、发达的中国社会中，这项务实的随机对照试验旨在研究 6 个月非专业卫生工作者干预对香港分租公寓单元中居住的糖尿病风险人群的糖尿病管理效果。
在这项试验中，将招募 222 名居住在住房条件较差且有糖尿病风险的中国初级照顾者，他们来自在香港低收入地区服务、并拥有大量分租公寓的非营利组织。采用 6 个月候补名单对照法，参与者将被随机分配接受 6 个月的非专业卫生工作者干预，干预内容包括 5 个部分：（1）非专业卫生工作者培训和支持；（2）卫生专业人员培训；（3）制定针对家庭健康和营养需求的目标护理计划；（4）病例管理方法；（5）为非专业卫生工作者提供经济补贴以维持实践。对照组将接受常规护理和有关糖尿病风险管理的健康信息。试验的入口和出口评估将采集糖化血红蛋白（HbA1c）和空腹血糖作为主要结局。
我们的随机对照试验是第一项研究非专业卫生工作者干预对居住在住房条件较差的低收入中国人群中前驱糖尿病管理效果的试验之一。这项研究可以为考虑向社区中具有糖尿病风险的人群提供替代服务提供依据，为那些人群提供一种由社区卫生工作者支持的护理选择，并增强护理提供者的社区参与度。本研究尝试使用混合方法研究设计评估非专业卫生工作者干预的影响。尽管这项研究具有贡献，但由于所有参与者都将从服务贫困人群的非营利组织招募，因此可能存在抽样偏差。
中国临床试验注册中心 ChiCTR2100052080。网址：https://www.chictr.org.cn/edit.aspx?pid=134928&htm=4。
