Effect of a bicultural community health worker on completion of diabetes education in a hispanic population

Eileen Corkery, Carmen Palmer, Mary E. Foley, Clyde B. Schechter, Leah Frisher, Sheila H. Roman

Research output: Contribution to journalArticle

152 Citations (Scopus)

Abstract

OBJECTIVE - To determine the effect of a bicultural community health worker (CHW) on completion of diabetes education in an inner-city. Hispanic patient population and to evaluate the impact of completion of the education program on patient knowledge, self-care behaviors, and glycemic control. RESEARCH DESIGN AND METHODS - Patients were randomized into CHW intervention and non-CHW intervention groups. All patients received individualized, comprehensive diabetes education from a certified diabetes nurse educator after baseline demographic information, diabetes knowledge, diabetes self- care practices, and glycohemoglobin levels were assessed. Rates of education program completion were determined diabetes knowledge, self-care practices, and glycohemoglobin levels were reassessed at program completion and at a later postprogram follow-up medical appointment and compared to baseline. Logistic regression analysis and the Mantel-Haenszel χ2 statistic were used to determine the effect of the CHW assignment on program completion. Analyses of covariance were performed with end-of-treatment behavior scores, knowledge scores, and glycohemoglobin levels as outcome variables, controlling for baseline values and testing for the effect of CHW assignment. RESULTS - Of 64 patients enrolled in the study 40 (63%) completed and 24 (37%) dropped out before completing the diabetes education program. Of the patients having CHW intervention, 80% completed the education program, compared with 47% of patients without CHW intervention (P = 0.01). 'Dropouts' were younger (age 47.5 ± 12.5 years [mean ± SDI]) compared with patients who completed the program (55.9 ± 9.9 years) (P = 0.004). Dropout status showed no significant relationship to educational level achieved or literacy level. For the program 'completers,' knowledge levels and selected self-care practices significantly improved, and glycohemoglobin levels improved from a baseline level of 11.7% to 9.9% at program completion (p = 0.004) and 9.5% at the postprogram follow- up (P < 0.001). The effect of the CHW assignment on program completion, controlling for financial status and language spoken, was extremely robust (P = 0.007). The effect of the CHW on knowledge, self-care behavior, or glycohemoglobin outcome variables was not statistically significant. CONCLUSIONS - These findings suggest that intervention with a bicultural CHW improved rates of completion of a diabetes education program in an inner- city Hispanic patient population irrespective of literacy or educational levels attained. Our data further suggests that completion of individualized diabetes educational strategies leads to improved patient knowledge, self- care behaviors, and glycemic control.

Original languageEnglish (US)
Pages (from-to)254-257
Number of pages4
JournalDiabetes Care
Volume20
Issue number3
StatePublished - Mar 1997
Externally publishedYes

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Hispanic Americans
Education
Self Care
Population
Behavior Control
Appointments and Schedules
Research Design
Language
Logistic Models
Nurses
Regression Analysis
Demography
Health

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

Cite this

Corkery, E., Palmer, C., Foley, M. E., Schechter, C. B., Frisher, L., & Roman, S. H. (1997). Effect of a bicultural community health worker on completion of diabetes education in a hispanic population. Diabetes Care, 20(3), 254-257.

Effect of a bicultural community health worker on completion of diabetes education in a hispanic population. / Corkery, Eileen; Palmer, Carmen; Foley, Mary E.; Schechter, Clyde B.; Frisher, Leah; Roman, Sheila H.

In: Diabetes Care, Vol. 20, No. 3, 03.1997, p. 254-257.

Research output: Contribution to journalArticle

Corkery, E, Palmer, C, Foley, ME, Schechter, CB, Frisher, L & Roman, SH 1997, 'Effect of a bicultural community health worker on completion of diabetes education in a hispanic population', Diabetes Care, vol. 20, no. 3, pp. 254-257.
Corkery, Eileen ; Palmer, Carmen ; Foley, Mary E. ; Schechter, Clyde B. ; Frisher, Leah ; Roman, Sheila H. / Effect of a bicultural community health worker on completion of diabetes education in a hispanic population. In: Diabetes Care. 1997 ; Vol. 20, No. 3. pp. 254-257.
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abstract = "OBJECTIVE - To determine the effect of a bicultural community health worker (CHW) on completion of diabetes education in an inner-city. Hispanic patient population and to evaluate the impact of completion of the education program on patient knowledge, self-care behaviors, and glycemic control. RESEARCH DESIGN AND METHODS - Patients were randomized into CHW intervention and non-CHW intervention groups. All patients received individualized, comprehensive diabetes education from a certified diabetes nurse educator after baseline demographic information, diabetes knowledge, diabetes self- care practices, and glycohemoglobin levels were assessed. Rates of education program completion were determined diabetes knowledge, self-care practices, and glycohemoglobin levels were reassessed at program completion and at a later postprogram follow-up medical appointment and compared to baseline. Logistic regression analysis and the Mantel-Haenszel χ2 statistic were used to determine the effect of the CHW assignment on program completion. Analyses of covariance were performed with end-of-treatment behavior scores, knowledge scores, and glycohemoglobin levels as outcome variables, controlling for baseline values and testing for the effect of CHW assignment. RESULTS - Of 64 patients enrolled in the study 40 (63{\%}) completed and 24 (37{\%}) dropped out before completing the diabetes education program. Of the patients having CHW intervention, 80{\%} completed the education program, compared with 47{\%} of patients without CHW intervention (P = 0.01). 'Dropouts' were younger (age 47.5 ± 12.5 years [mean ± SDI]) compared with patients who completed the program (55.9 ± 9.9 years) (P = 0.004). Dropout status showed no significant relationship to educational level achieved or literacy level. For the program 'completers,' knowledge levels and selected self-care practices significantly improved, and glycohemoglobin levels improved from a baseline level of 11.7{\%} to 9.9{\%} at program completion (p = 0.004) and 9.5{\%} at the postprogram follow- up (P < 0.001). The effect of the CHW assignment on program completion, controlling for financial status and language spoken, was extremely robust (P = 0.007). The effect of the CHW on knowledge, self-care behavior, or glycohemoglobin outcome variables was not statistically significant. CONCLUSIONS - These findings suggest that intervention with a bicultural CHW improved rates of completion of a diabetes education program in an inner- city Hispanic patient population irrespective of literacy or educational levels attained. Our data further suggests that completion of individualized diabetes educational strategies leads to improved patient knowledge, self- care behaviors, and glycemic control.",
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AU - Roman, Sheila H.

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N2 - OBJECTIVE - To determine the effect of a bicultural community health worker (CHW) on completion of diabetes education in an inner-city. Hispanic patient population and to evaluate the impact of completion of the education program on patient knowledge, self-care behaviors, and glycemic control. RESEARCH DESIGN AND METHODS - Patients were randomized into CHW intervention and non-CHW intervention groups. All patients received individualized, comprehensive diabetes education from a certified diabetes nurse educator after baseline demographic information, diabetes knowledge, diabetes self- care practices, and glycohemoglobin levels were assessed. Rates of education program completion were determined diabetes knowledge, self-care practices, and glycohemoglobin levels were reassessed at program completion and at a later postprogram follow-up medical appointment and compared to baseline. Logistic regression analysis and the Mantel-Haenszel χ2 statistic were used to determine the effect of the CHW assignment on program completion. Analyses of covariance were performed with end-of-treatment behavior scores, knowledge scores, and glycohemoglobin levels as outcome variables, controlling for baseline values and testing for the effect of CHW assignment. RESULTS - Of 64 patients enrolled in the study 40 (63%) completed and 24 (37%) dropped out before completing the diabetes education program. Of the patients having CHW intervention, 80% completed the education program, compared with 47% of patients without CHW intervention (P = 0.01). 'Dropouts' were younger (age 47.5 ± 12.5 years [mean ± SDI]) compared with patients who completed the program (55.9 ± 9.9 years) (P = 0.004). Dropout status showed no significant relationship to educational level achieved or literacy level. For the program 'completers,' knowledge levels and selected self-care practices significantly improved, and glycohemoglobin levels improved from a baseline level of 11.7% to 9.9% at program completion (p = 0.004) and 9.5% at the postprogram follow- up (P < 0.001). The effect of the CHW assignment on program completion, controlling for financial status and language spoken, was extremely robust (P = 0.007). The effect of the CHW on knowledge, self-care behavior, or glycohemoglobin outcome variables was not statistically significant. CONCLUSIONS - These findings suggest that intervention with a bicultural CHW improved rates of completion of a diabetes education program in an inner- city Hispanic patient population irrespective of literacy or educational levels attained. Our data further suggests that completion of individualized diabetes educational strategies leads to improved patient knowledge, self- care behaviors, and glycemic control.

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