A pilot study of a Community Health Agent-led type 2 diabetes self-management program using MI-based approaches in a public primary care center in São Paulo, Brazil
do Valle Nascimento TM, Resnicow K, Nery M, Brentani A, Kaselitz E, Agrawal P, M and S, Heisler M
BMC Health Serv Res. 2017 Jan 13;17(1):32. [Pubmed Abstract]
Rates of noncommunicable diseases (NCDs) such as type 2 diabetes are escalating in low and middle-income countries such as Brazil. Scalable primary care-based interventions are needed to improve self-management and clinical outcomes of adults with diabetes. This pilot study examines the feasibility, acceptability, and outcomes of training community health agents (CHAs) in Motivational Interviewing (MI)-based counseling for patients with poorly controlled diabetes in a primary care center in São Paulo, Brazil.
Nineteen salaried CHAs participated in 32 h of training in MI and behavioral action planning. With support from booster training sessions, they used these skills in their regular monthly home visits over a 6 month period with 57 diabetes patients with baseline HbA1cs > 7.0%. The primary…
Fam Pract. 2016 Oct;33(5):523-8. [Pubmed Abstract]
Improving diabetes care and outcomes with community health workers
Kane EP, Collinsworth AW, Schmidt KL, Brown RM, Snead CA, Barnes SA, Fleming NS, Walton JW
Type II diabetes continues to be a major health problem in USA, particularly in minority populations. The Diabetes Equity Project (DEP), a clinic-based diabetes self-management and education program led by community health workers (CHWs), was designed to reduce observed disparities in diabetes care and outcomes in medically underserved, predominantly Hispanic communities.
The purpose of this study was to evaluate the impact of the DEP on patients’ clinical outcomes, diabetes knowledge, self-management skills, and quality of life.
The DEP was implemented in five community clinics from 2009 to 2013 and 885 patients completed at least two visits with the CHW. Student’s paired t-tests were used to compare baseline clinical indicators with…
Popul Health Manag. 2016 Jun 6. [Pubmed Abstract]
Combining the High Tech with the Soft Touch: Population Health Management Using eHealth and Peer Support
Kowitt SD, Tang PY, Peeples M, Duni J, Peskin S, Fisher EB
Integration of diverse approaches may offer paths to meeting population health challenges such as how to provide ongoing diabetes self management support. With the engagement of peer support and the reach of eHealth (and the effectiveness and feasibility of both approaches), we therefore discuss how the “high-tech” of eHealth could be integrated with the “soft-touch” of peer support to manage the health of populations. Our model integrates eHealth with lay health coaching for people living with Type 2 diabetes receiving care from a primary care clinic. Formative research with patients, providers, and staff raised several potential challenges for the program, including how to best engage patients, training and qualifications of the health coaches, and…