Robyn McDermott|B. Schmidt|Cilla Preece|Vickie Owens|Sean Taylor|Ming Li|Adrian Esterman
Community health workers improve diabetes care in remote Australian Indigenous communities: results of a pragmatic cluster randomized controlled trial
University of South Australia|University of South Australia|University of South Australia|University of South Australia|University of South Australia|University of South Australia|University of South Australia
health outcomes indigenous australians diabetes remote areas remain poor including high rates avoidable complications could reduced better primary level care aimed evaluate effectiveness communitybased healthworker led case management approach care indigenous adults poorly controlled type 2 diabetes primary care services remote northern australiatwo hundred thirteen adults poorly controlled diabetes hba1c 85 significant comorbidities 12 remote communities randomly assigned service cluster receive chronic care coordination communitybased health worker supported clinical outreach team waitlist control group received usual careat baseline mean age participants 479 years 624 female half aboriginal half identified torres strait islander 67 less 12 years education 39 smokers median income 18200 47 unemployed mean hba1c 107 93 mmolmol bmi 325 followup 18 months hba1c reduction significantly greater intervention group 10 vs 02 se diff 02 p 002 significant differences groups blood pressure lipid profile bmi renal function intervention group participants likely receive nutrition dental services according scheduled care plans smoking rates unchangeda culturally safe community level healthworker led model diabetes care high risk patients effective improving diabetes control remote indigenous australian communities poor access mainstream services approach effective remote settings requires longer term evaluation capture accrued benefitsanzctr 12610000812099 registered 29 september 2010