Primary Care

Mobile-Enhanced Peer Support for African Americans with T2D

J Gen Intern Med. 2020 Jul 22. doi: 10.1007/s11606-020-06011-w. [Pubmed Abstract]

Caroline Presley, April Agne, Tanya Shelton, Robert Oster, Andrea Cherrington

Background
Peer support has been shown to improve diabetes self-management and control, but no standard exists to link peer support interventions to clinical care.

Objective
To compare a community-based diabetes self-management education (DSME) plus mobile health (mHealth)-enhanced peer support intervention to community-based diabetes self-management education (DSME) alone for African American adults with poorly controlled type 2 diabetes.

Design
A randomized controlled trial.

Participants
African American adults, age > 19 years, receiving care within a safety-net healthcare system in Jefferson County, Alabama, with a diagnosis of type 2 diabetes and a hemoglobin A1c (A1C) ≥ 7.5%.

Interventions
Participants in the intervention group received community-based diabetes self-management education (DSME)…

Documenting CHW Roles in Primary Care: Contributions to Evidence-Based Integration Into Health Care Teams, 2015

J Ambul Care Manage. 2017 Oct/Dec;40(4):305-315. [Pubmed Abstract]

Reinschmidt KM, Ingram M, Morales S, Sabo SJ, Blackburn J, Murrieta L, David C, Carvajal SC

Abstract
The Patient Protection and Affordable Care Act provided community health workers (CHWs) with new opportunities, and current efforts develop evidence-based guidelines for CHW integration into clinical teams. This qualitative study documents CHW roles and activities in 3 federally qualified health care centers in southern Arizona. Community health worker clinical roles, activities, and integration varied by health center and were in flux. Integration included complementary roles, scheduled and everyday communications with team members, and documentation in the electronic health records. These findings contribute to evidence-based guidelines for CHW integration into clinical teams that are critical to maximizing CHW contributions to patient health improvements.

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]

Background
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.

Methods
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…