Tiffany L. Gary|Marian Batts-Turner|Hsin Chieh Yeh|Felicia Hill-Briggs|Lee Bone|Nae Yuh Wang|David M. Levine|Neil R. Powe|Christopher D. Saudek|Martha N. Hill|Maura McGuire|Frederick L. Brancati
The Effects of a Nurse Case Manager and a Community Health Worker Team on Diabetic Control, Emergency Department Visits, and Hospitalizations Among Urban African Americans With Type 2 Diabetes Mellitus
although african american adults bear disproportionate burden diabetes mellitus dm randomized controlled trials tested culturally appropriate interventions improve dm carewe randomly assigned 542 african americans type 2 dm enrolled urban managed care organization either intensive minimal intervention group intensive intervention group consisted components minimal intervention plus individualized culturally tailored care provided nurse case manager ncm community health worker chw using evidencebased clinical algorithms feedback primary care providers eg physicians nurse practitioners physician assistants minimal intervention consisted mailings telephone calls every 6 months remind participants preventive screenings data diabetic control collected baseline 24 months blind observers data emergency department er visits hospitalizations assessed using administrative dataat baseline participants mean age 58 years 73 women 50 living poverty 24 months compared minimal intervention group intensive intervention group 23 less likely er visits rate difference rd 145 adjusted rate ratio rr 077 95 confidence interval ci 059100 ontreatment analyses rate reduction strongest patients received ncm chw visits rd 310 adjusted rr 066 95 ci 043100 rate reduction downward arrow 34these data suggest culturally tailored intervention conducted ncmchw team reduced er visits urban african americans type 2 dmclinicaltrialsgov identifier nct00022750