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Diabetes Prevention: Interventions Engaging Community Health Workers Improve Risk Factors and Health Outcomes
The Community Preventive Services Task Force recommends interventions engaging community health workers for diabetes prevention. The finding is based on a systematic review that found sufficient evidence of effectiveness in improving glycemic control and weight-related outcomes among people at increased risk for type 2 diabetes. When implemented in underserved communities, these interventions can improve health, reduce health disparities, and enhance health equity.
Evidence from the review shows that programs using CHWs to target populations at increased risk of type 2 diabetes improved health outcomes, including blood sugar control (HbA1C, fasting blood glucose) and weight reduction. They also reduced rates of new-onset diabetes.
What are Community Health Workers (CHWs)?
Community health workers (including promotores de salud, community health representatives, community health advisors, and others) are frontline public health workers who serve as a bridge between underserved communities and healthcare systems. They are from, or have a close understanding of, the community they serve. CHWs often receive on-the-job training and may work as volunteers. CHWs may work alone or as part of an intervention team comprising counselors, clinicians, or other health professionals.
Interventions that engage CHWs to focus on diabetes prevention aim to reduce one or more risk factors for type 2 diabetes among members of the community.
- CHWs deliver program content through group sessions or one-on-one interactions with individuals at increased risk for type 2 diabetes.
- CHWs may provide education about diabetes prevention and lifestyle modification, or informal counseling, coaching, and extended support for community members.
- Intervention activities may take place in homes or community-based settings.
Why is the Task Force Recommendation Important?
Diabetes was the seventh leading cause of death in the United States in 2013 (CDC, 2016). Diabetes also has a large economic impact, as more than 20% of health care spending is for people with diagnosed diabetes (CDC, 2016).
Almost 29 million Americans have diabetes, and about one-third of US adults (86 million) have prediabetes. Of these adults, many are unaware that they have a condition or that they should seek medical counseling. For people with prediabetes, taking part in a structured lifestyle change program can reduce the risk of developing type 2 diabetes.
CHWs are able to provide patients with culturally appropriate information and education on diabetes prevention, lifestyle counseling, and informal counseling and social support. They are also able to conduct home visits to ensure patients get the services they need.
What are the Task Force and Community Guide?
- The Community Preventive Services Task Force (Task Force) is an independent, nonfederal, unpaid panel of public health and prevention experts. The Task Force works to improve the health of all Americans by providing evidence-based recommendations about community preventive programs, services, and policies to improve health. Its members represent a broad range of research, practice, and policy expertise in community prevention services, public health, health promotion, and disease prevention.
- The Guide to Community Preventive Services (The Community Guide) is a collection of all the evidence-based findings and recommendations of the Community Preventive Services Task Force and is available online at www.thecommunityguide.org.
American Diabetes Association (2015). Facts about type 2. http://www.diabetes.org/diabetes-basics/type-2/facts-about-type-2.html?loc=db-slabnav
Centers for Disease Control and Prevention (2016). Diabetes. https://www.cdc.gov/chronicdisease/resources/publications/aag/diabetes.htm
For More Information
CDC, The CHW Toolkit