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Randomized Controlled Trial of a Community Health Worker Self-Management Support Intervention Among Low-Income Adults With Diabetes, Seattle, Washington, 2010–2014

ORIGINAL RESEARCH — Volume 14 — February 9, 2017

PEER REVIEWED

A total of 1,438 patients were identified as potentially eligible. After excluding 993 because they could not be reached (n = 703) , declined (n = 221) , or for whom information was incomplete (n = 69), 445 patients were screened by telephone for eligibility. From the 445, we excluded 158: 79 who were eligible (25 declined and 54 were not enrolled or had incomplete information) and 79 who were not eligible (9 because of age, 19 because of health issues; 9 because of homelessness, 23 because income was too high, 6 were involved in other studies, 6 were moving, and 7 were unable to be reached). The remaining 287 who were eligible were randomized into control (n = 142) and intervention (n = 145) groups. In the intervention group, 144 (99%), completed visit 1, 140 (97%) completed visit 2, 138 (95%) completed visit 3, 132 (91%) completed visit 4, 80 (55%) completed visit 5 (which was optional), and 130 (89%) completed the 12-month exit visit. In the control group, 134 (94%) completed the 12-month exit visit; 29 (20%) declined the education visit, 97 (68%) participated in the exit education visit, and 8 (6%) were control closed (3 were unwilling to continue, 4 were lost to follow up, and 1 was withdrawn by study staff). In the intervention group, 15 (10%) were intervention closed (7 were unwilling to continue, 5 were lost to follow-up, 2 moved out of King County, and 1 was lost for other reason).

Figure 1. Recruitment of patients for Peer Support for Achieving Independence in Diabetes (Peer-AID) trial using community health workers to provide self-management support among low-income adults with diabetes, Seattle, Washington, 2010–2014. 

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Figure 2. Decreases in glycated hemoglobin A1c (HbA1c ) from baseline to 12 months by intervention arm, total study population, subgroup with HbA1c higher than 9%, and subgroup with HbA1c higher than 10%, Peer Support for Achieving Independence in Diabetes (Peer-AID) trial using community health workers to provide self-management support among low-income adults with diabetes, Seattle, Washington, 2010–2014. P = .046 for the adjusted difference in HbA1c value between the control and intervention groups for the subgroup with HbA1c higher than 10%.

Population Decrease in HbA1c
Control Intervention Adjusted Difference
Total (n = 287) −0.33 −0.51 −0.14
Subgroup HbA1c >9% (n = 133) −0.98 −1.52 −0.60
Subgroup HbA1c >10% (n = 72) −1.12 −1.93 −1.23

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