Community Health Worker Interventions for Latinos With Type 2 Diabetes: a Systematic Review of Randomized Controlled Trials

Abstract

This systematic review aimed to synthesize glucose (HbA1c) outcomes of community health worker (CHW)-delivered interventions for Latinos with type 2 diabetes that were tested in randomized controlled trials and to summarize characteristics of the targeted populations and interventions, including the background, training, and supervision of the CHWs. Searches of PubMed and Google Scholar databases and references from selected articles identified 12 studies that met the inclusion criteria. Of these, seven reported statistically significant improvements in HbA1c. Study participants were largely low-income, female, and Spanish-speaking and had uncontrolled diabetes. The CHWs led the interventions alone, in pairs, or as part of a team. Interventions varied considerably in session time, duration, and number. Most met standards for tailored, high-intensity interventions and half were theory-based. Overall, methodological quality was good but there were inconsistencies in the reporting of key information. Future research should report in greater detail CHW background, training, and supervision; examine factors associated with intervention effectiveness; and provide data on cost and cost-effectiveness.

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Acknowledgments

We acknowledge the contributions of Sally A. Gore, Judith Nordberg, and Karen Ronayne (University of Massachusetts Medical School). Milagros C. Rosal, Ph.D., received support from the NIMHD grant no. 1 P60 MD006912 and the CDC grant no. U48 DP001933.

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Conflict of Interest

Tariana V. Little, Monica L. Wang, Eida M. Castro, and Julio Jiménez declare that they have no conflict of interest.

Milagros C. Rosal has received payment for presenting part of this work at annual meetings of the American Diabetes Association.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Correspondence to Milagros C. Rosal.

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This article is part of the Topical Collection on Lifestyle Management to Reduce Diabetes/Cardiovascular Risk

Appendix 1: Search Algorithms

Appendix 1: Search Algorithms

Google Scholar

community health latino OR hispanic OR “mexican american” OR minority “diabetes intervention”

PubMed

community AND (management OR intervention OR prevention OR education OR pilot OR trial OR programs) AND (chronic disease OR diabetes) AND (hispanic OR latino OR mexican american OR minorit*)

Extended PubMed Search Algorithm

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Little, T.V., Wang, M.L., Castro, E.M. et al. Community Health Worker Interventions for Latinos With Type 2 Diabetes: a Systematic Review of Randomized Controlled Trials. Curr Diab Rep 14, 558 (2014). https://doi.org/10.1007/s11892-014-0558-1

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Keywords

  • Community health worker
  • Randomized control trial
  • Type 2 diabetes
  • Hispanic
  • Culture
  • Literacy