Michele Heisler|Hwajung Choi|Gloria Palmisano|Rebecca Mase|Caroline R. Richardson|Angela Fagerlin|Víctor M. Montori|Michael S. Spencer|Laurence C. An
Comparison of Community Health Worker–Led Diabetes Medication Decision-Making Support for Low-Income Latino and African American Adults With Diabetes Using E-Health Tools Versus Print Materials
General Department of Preventive Medicine|General Department of Preventive Medicine|Community Health Partnership|Research for Equity And Community Health Trust|University of Michigan–Ann Arbor|Day Family Medicine|General Department of Preventive Medicine|Institute of Nutrition, Metabolism and Diabetes|General Department of Preventive Medicine
background health care centers serving lowincome communities scarce resources support medication decision making among patients poorly controlled diabetes objective compare outcomes community health worker use tailored interactive webbased tablet computerdelivered tool idecide use print educational materials design randomized 2group trial conducted 2011 2013 clinicaltrialsgov nct01427660 setting community health center detroit michigan serving latino african american lowincome population participants 188 adults hemoglobin a1c value greater 75 55 reported questions concerns difficulty taking diabetes medications intervention participants randomly assigned receive 1 2hour session community health worker used idecide printed educational materials 2 followup calls measurements primary outcomes changes knowledge antihyperglycemic medications patientreported medication decisional conflict satisfaction antihyperglycemic medication information also examined changes diabetes distress selfefficacy medication adherence hemoglobin a1c values results ninetyfour percent participants completed 3month followup groups improved across measures idecide participants reported greater improvements satisfaction medication information helpfulness p 0007 clarity p 003 diabetes distress compared print materials group p 0001 outcomes differ groups limitations study conducted 1 health center short period community health workers experienced behavioral counseling thereby possibly mitigating need additional support tools conclusion outcomes similarly improved among participants receiving types decisionmaking support diabetes medication longerterm evaluations necessary determine whether greater improvements satisfaction medication information diabetes distress achieved idecide group 3 months translate better longerterm diabetes outcomes primary funding source agency healthcare research quality national institute diabetes digestive kidney diseases