scope of training would practice improve effectiveness; 5 roles identified for CHWs Behaviour modification and diabetes control A literature review() examining the impact of controlled trials of patient-centered interventions focusing on lifestyle activities for type 2 diabetic patients simulated the long-term outcomes for these interventions on the Dutch diabetic population using a computer-based model. findings demonstrated that the lifestyle interventions projected a reduction in lifetime cumulative incidence of cardiovascular complications by up to 6%. (Life-years gained per participant: 0.34 & Quality adjusted Life years (QALYs) gained per participant: 0.14). Loss to follow up In another prospective RCT () conducted in the United States among Hispanic populations in the inner city to determine the effectiveness of CHW led interventions in comparison to usual clinic practice found significantly greater proportions of patients enrolled in the standard provider care group (50%) and the case management group (43%) were lost to follow-up, as compared with the CHW group (28%) Cost-effectiveness The University of Texas Community Outreach (UTCO) intervention() is a community-based diabetes education and self-management programme that includes home-based CHW visits, classroom health education classes, nutrition classes, exercise classes, and counseling sessions. This followed a cohort of participants whose A1c levels were above 7% at baseline, but fell to 7% or below during the course of the 18-month intervention The used real-world cost structure and assumed ongoing annual costs at the 50% level. Using the Archimedes model, the UTCO intervention is expected to reduce the risk of a myocardial infarction by 2.6%, foot ulcers by 5.6%, and foot amputation by 3.5%. A1c levels will fall by 11.7%, and 413.52 life years will be gained through the intervention over a 20-year period among the 30 participants accounting for health disutility weights, the UTCO intervention results in an incremental gain of 394.92 QALYs amongst 30 participants
scope of practice training would improve effectiveness; 5 roles identified for CHWs Behaviour modification and diabetes control A literature review() examining the impact of controlled trials of patient-centered interventions focusing on lifestyle activities for type 2 diabetic patients simulated the long-term outcomes for these interventions on the Dutch diabetic population using a computer-based model. findings demonstrated that the lifestyle interventions projected a reduction in lifetime cumulative incidence of cardiovascular complications by up to 6%. (Life-years gained per participant: 0.34 & Quality adjusted Life years (QALYs) gained per participant: 0.14). Loss to follow up In another prospective RCT () conducted in the United States among Hispanic populations in the inner city to determine the effectiveness of CHW led interventions in comparison to usual clinic practice found significantly greater proportions of patients enrolled in the standard provider care group (50%) and the case management group (43%) were lost to follow-up, as compared with the CHW group (28%) Cost-effectiveness The University of Texas Community Outreach (UTCO) intervention() is a community-based diabetes education and self-management programme that includes home-based CHW visits, classroom health education classes, nutrition classes, exercise classes, and counseling sessions. This followed a cohort of participants whose A1c levels were above 7% at baseline, but fell to 7% or below during the course of the 18-month intervention The used real-world cost structure and assumed ongoing annual costs at the 50% level. Using the Archimedes model, the UTCO intervention is expected to reduce the risk of a myocardial infarction by 2.6%, foot ulcers by 5.6%, and foot amputation by 3.5%. A1c levels will fall by 11.7%, and 413.52 life years will be gained through the intervention over a 20-year period among the 30 participants accounting for health disutility weights, the UTCO intervention results in an incremental gain of 394.92 QALYs amongst 30 participants