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A Community Health Worker–Delivered Intervention in African American Women with Type 2 Diabetes: A 12‐Month Randomized Trial
Author(s) -
Lutes Lesley D.,
Cummings Doyle M.,
Littlewood Kerry,
Dinatale Emily,
Hambidge Bertha
Publication year - 2017
Publication title -
obesity
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.438
H-Index - 199
eISSN - 1930-739X
pISSN - 1930-7381
DOI - 10.1002/oby.21883
Subject(s) - medicine , type 2 diabetes , randomized controlled trial , diabetes mellitus , weight loss , obesity , blood pressure , african american , physical therapy , endocrinology , ethnology , history
Objective To evaluate the effectiveness of a community health worker (CHW)–delivered lifestyle intervention for African American women with type 2 diabetes. Methods Participants were randomized to either 16 phone‐based lifestyle intervention sessions aimed at making small changes in their diet and activity or 16 educational mailings sent across 12 months. Main outcomes included glycosylated hemoglobin (HbA1c), blood pressure (BP), and weight (kg) changes. Results Two hundred middle‐aged (mean = 53 ± 10.24 years), rural, African American women with moderate obesity (mean BMI = 37.7 ± 8.02) and type 2 diabetes (mean HbA1c = 9.1 ± 1.83) were enrolled. At 12 months, the intervention group exhibited no significant differences in HbA1c (−0.29 ± 1.84 vs. + 0.005 ± 1.61; P = 0.789) or BP (−1.01 ± 20.46/+0.66 ± 13.24 vs. + 0.22 ± 25.33/−2.87 ± 1.52; P = 0.100) but did exhibit greater weight loss (−1.35 ± 6.22 vs. −0.39 ± 4.57 kg, respectively; P = 0.046) compared with controls. Exploratory post hoc analyses revealed that participants not using insulin had significantly greater reductions in HbA1c (−0.70 ± 1.86 vs. + 0.07 ± 2.01; P = 0.000), diastolic BP (−5.17 ± 14.16 vs. −3.40 ± 14.72 mmHg; P = 0.035), and weight (−2.36 ± 6.59 vs. −1.64 ± 4.36 kg; P = 0.003) compared to controls not on insulin. Conclusions A phone‐based CHW intervention resulted in no significant improvements in HbA1c or BP but did demonstrate modest improvements in weight. Women not using insulin showed significant improvements in all primary outcomes.