Latino Health Access
Allison Slater, Patricia J. Cantero, Guillermo Jiménez Álvarez, Brett S. Cervantes, America Bracho, John Billimek
Abstract
Community-initiated health interventions fill important gaps in access to health services. This study examines the effectiveness of a community-initiated health intervention to improve diabetes management in an underserved community of color using a retrospective observational study, comparing a study intervention, the Latino Health Access Diabetes Self-Management Program (LHA-DSMP), with usual care. The LHA-DSMP is a 12-session community health worker ( promotor/a ) intervention developed and implemented by a community-based organization in a medically underserved area. Usual care was delivered at a federally qualified health center in the same geographic area. Participants were 688 predominantly Spanish-speaking Latinx adults with type 2 diabetes. The main outcome was change in glycemic control (glycosylated hemoglobin [HbA 1c ]) from baseline to follow-up. At 14-week follow-up, mean (95% CI) HbA 1c decrease was −1.1 (−1.3 to −0.9; P < .001) in the LHA-DSMP cohort compared with −0.3 (−0.4 to −0.2; P < .001) in the comparison cohort. Controlling for baseline differences between cohorts, the adjusted difference-in-differences value in HbA 1c was −0.6 (−0.8 to −0.3; P < .001) favoring the LHA-DSMP. A community-initiated promotor/a -led educational program for diabetes self-management is associated with clinically significant improvement in blood sugar control, superior to what was observed with usual medical care.