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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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.
Compliance with Ethics Guidelines
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.
This article is part of the Topical Collection on Lifestyle Management to Reduce Diabetes/Cardiovascular Risk
Appendix 1: Search Algorithms
Appendix 1: Search Algorithms
community health latino OR hispanic OR “mexican american” OR minority “diabetes intervention”
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
(“residence characteristics”[MeSH Terms] OR (“residence”[All Fields] AND “characteristics”[All Fields]) OR “residence characteristics”[All Fields] OR “community”[All Fields]) AND ((“organization and administration”[MeSH Terms] OR (“organization”[All Fields] AND “administration”[All Fields]) OR “organization and administration”[All Fields] OR “management”[All Fields] OR “disease management”[MeSH Terms] OR (“disease”[All Fields] AND “management”[All Fields]) OR “disease management”[All Fields]) OR (“Intervention (Amstelveen)”[Journal] OR “Interv Sch Clin”[Journal] OR “intervention”[All Fields]) OR (“prevention and control”[Subheading] OR (“prevention”[All Fields] AND “control”[All Fields]) OR “prevention and control”[All Fields] OR “prevention”[All Fields]) OR (“education”[Subheading] OR “education”[All Fields] OR “educational status”[MeSH Terms] OR (“educational”[All Fields] AND “status”[All Fields]) OR “educational status”[All Fields] OR “education”[All Fields] OR “education”[MeSH Terms]) OR (“Pilot Evanst Hosp”[Journal] OR “pilot”[All Fields]) OR (“clinical trials as topic”[MeSH Terms] OR (“clinical”[All Fields] AND “trials”[All Fields] AND “topic”[All Fields]) OR “clinical trials as topic”[All Fields] OR “trial”[All Fields]) OR programs[All Fields]) AND ((“chronic disease”[MeSH Terms] OR (“chronic”[All Fields] AND “disease”[All Fields]) OR “chronic disease”[All Fields]) OR (“diabetes mellitus”[MeSH Terms] OR (“diabetes”[All Fields] AND “mellitus”[All Fields]) OR “diabetes mellitus”[All Fields] OR “diabetes”[All Fields] OR “diabetes insipidus”[MeSH Terms] OR (“diabetes”[All Fields] AND “insipidus”[All Fields]) OR “diabetes insipidus”[All Fields])) AND ((“hispanic americans”[MeSH Terms] OR (“hispanic”[All Fields] AND “americans”[All Fields]) OR “hispanic americans”[All Fields] OR “hispanic”[All Fields]) OR (“hispanic americans”[MeSH Terms] OR (“hispanic”[All Fields] AND “americans”[All Fields]) OR “hispanic americans”[All Fields] OR “latino”[All Fields]) OR (“mexican americans”[MeSH Terms] OR (“mexican”[All Fields] AND “americans”[All Fields]) OR “mexican americans”[All Fields] OR (“mexican”[All Fields] AND “american”[All Fields]) OR “mexican american”[All Fields]) OR (minorita[All Fields] OR minoritaire[All Fields] OR minoritaires[All Fields] OR minoritari[All Fields] OR minoritarian[All Fields] OR minoritarilor[All Fields] OR minoritario[All Fields] OR minoritarios[All Fields] OR minoritary[All Fields] OR minoritaten[All Fields] OR minoritatsbasen[All Fields] OR minorite[All Fields] OR minorites[All Fields] OR minoritet[All Fields] OR minoriteter[All Fields] OR minoriteternas[All Fields] OR minoritetsgrupper[All Fields] OR minoritetshelse[All Fields] OR minorities[All Fields] OR minorities/language[All Fields] OR minorities/women[All Fields] OR minorities’[All Fields] OR minoritis[All Fields] OR minoritisation[All Fields] OR minoritites[All Fields] OR minoritiy[All Fields] OR minoritization[All Fields] OR minoritize[All Fields] OR minoritized[All Fields] OR minoritizing[All Fields] OR minoritnich[All Fields] OR minority[All Fields] OR minority/admissions[All Fields] OR minority/disadvantaged[All Fields] OR minority/ethnic[All Fields] OR minority/human[All Fields] OR minority/immigrant[All Fields] OR minority/international[All Fields] OR minority/less[All Fields] OR minority/low[All Fields] OR minority/majority[All Fields] OR minority/minority[All Fields] OR minority/nonminority[All Fields] OR minority/specialist[All Fields] OR minority/white[All Fields] OR minority/women’s[All Fields] OR minority’[All Fields] OR minority’s[All Fields] OR minoritynurse[All Fields]))
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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
- Community health worker
- Randomized control trial
- Type 2 diabetes