Judith D. DePue|Shira Dunsiger|Andrew Seiden|Jeffrey D. Blume|Rochelle K. Rosen|Michael G. Goldstein|Ofeira Nu’usolia|John Tuitele|Stephen T. McGarvey
Nurse–Community Health Worker Team Improves Diabetes Care in American Samoa
Miriam Hospital|Brown University|Providence College|Miriam Hospital|Brown University|Providence College|Brown University|Providence College|Vanderbilt University|Miriam Hospital|Brown University|Providence College|American Samoa Government|Community Health Center|American Samoa Government|Community Health Center|Brown University|Providence College
objective evaluate effectiveness culturally adapted primary carebased nursecommunity health worker chw team intervention support diabetes selfmanagement diabetes control biologic measures research design methods two hundred sixtyeight samoan participants type 2 diabetes recruited community health center american samoa randomly assigned village clusters nursechw team intervention waitlist control group received usual care results participants mean age 55 years 62 female mean years education 125 years 41 employed mean hba1c 98 baseline 12 months mean hba1c significantly lower among chw participants compared usual care adjusting confounders b 053 se 021 p 003 odds making clinically significant improvement hba1c least 05 chw group twice odds usual care group controlling confounders p 005 significant differences blood pressure weight waist circumference 12 months groups conclusions culturally adapted nursechw team intervention able significantly improve diabetes control us territory american samoa represents important translation evidencebased model highrisk population resourcepoor setting