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Health Promot Pract. 2015 Jul;16(4):601-8. doi: 10.1177/1524839914557033. Epub 2014 Nov 5.

A Community Health Worker Intervention for Diabetes Self-Management Among the Tz'utujil Maya of Guatemala.

Author information

1
Emory University, Atlanta, GA, USA Mary.Micikas@gmail.com.
2
Emory University, Atlanta, GA, USA.
3
Duke University Medical Center, Durham, NC, USA.
4
Medical Anthropologist, Atlanta, GA, USA.
5
Organization for the Development of the Indigenous Maya, San Juan La Laguna, Guatemala.

Abstract

Despite the high prevalence of diabetes in rural Guatemala, there is little education in diabetes self-management, particularly among the indigenous population. To address this need, a culturally relevant education intervention for diabetic patients was developed and implemented in two rural communities in Guatemala. An evaluative research project was designed to investigate if the structured, community-led diabetes self-management intervention improved selected health outcomes for participants. A one-group, pretest-posttest design was used to evaluate the effectiveness of the educational intervention by comparing measures of health, knowledge, and behavior in patients pre- and postintervention. A survey instrument assessed health beliefs and practices and hemoglobin A1c (HgA1c) measured blood glucose levels at baseline and 4 months post initiation of intervention (n = 52). There was a significant decrease (1.2%) in the main outcome measure, mean HgA1c from baseline (10.1%) and follow-up (8.9%; p = .001). Other survey findings were not statistically significant. This study illustrates that a culturally specific, diabetes self-management program led by community health workers may reduce HgA1c levels in rural populations of Guatemala. However, as a random sample was not feasible for this study, this finding should be interpreted with caution. Limitations unique to the setting and patient population are discussed in this article.

KEYWORDS:

chronic disease; diabetes; health education; health promotion; international/cross-cultural health

PMID:
26113496
DOI:
10.1177/1524839914557033
[Indexed for MEDLINE]

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