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Obesity (Silver Spring). 2017 Jun 29. doi: 10.1002/oby.21883. [Epub ahead of print]

A community health worker-delivered intervention in African American women with type 2 diabetes: A 12-month randomized trial.

Author information

1
Department of Psychology, University of British Columbia, Kelowna, British Columbia, Canada.
2
Department of Family Medicine, Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA.
3
Center for Health Disparities, East Carolina University, Greenville, North Carolina, USA.
4
School of Social Work, University of South Florida, Tampa, Florida, USA.
5
Primary Care Mental Health Integration, Charlie Norwood Veterans Affairs Medical Center, Augusta, Georgia, USA.

Abstract

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.

PMID:
28660719
DOI:
10.1002/oby.21883
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