Community Health Workers Help Patients Manage Diabetes

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A community health worker discusses healthy eating with a patient.The Community Preventive Services Task Force (CPSTF) recommends interventions that engage community health workers to help patients manage their diabetes. The finding is based on a systematic review that shows patients who receive these interventions improve their glycemic and lipid control and reduce their healthcare use. Additionally, the available economic evidence suggests these interventions are cost-effective.

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.

How do Community Health Workers (CHWs) Improve Diabetes Management?

Interventions engaging community health workers for diabetes management aim to improve diabetes care and self-management behaviors among patients. These interventions use one or more of the following models of care:

  • Screening and health education
  • Outreach, enrollment, and information
  • Member of a care delivery team
  • Patient navigation
  • Community organizers

Overall, interventions engaging community health workers improved patients’ glycemic or blood sugar control (HbA1c, proportion at goal A1c [A1c < 7.0%], fasting blood glucose) and reduced their healthcare use. Improvements were also seen for self-reported lifestyle changes, such as increased physical activity and improved nutrition.

Why is the CPSTF Recommendation Important?

  • More than 23 million Americans are living with diagnosed diabetes (CDC 2017).
  • The total direct and indirect estimated cost of diabetes has risen from $174 billion in 2007 to $245 billion in 2012 (CDC 2017).
  • Diabetes increases patients’ risk of heart attacks, strokes, nerve damage, eye damage and blindness, kidney disease, and more. When properly managed, however, patients can reduce these risks (CDC 2017).

What are the CPSTF and Community Guide?

  • The Community Preventive Services Task Force (CPSTF) is an independent, nonfederal panel of public health and prevention experts whose members are appointed by the CDC Director. CPSTF provides information for a wide range of decision makers on programs, services, and other interventions aimed at improving population health. Although CDC provides administrative, scientific, and technical support for the Task Force, the recommendations developed are those of CPSTF and do not undergo review or approval by CDC.
  • 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.

Additional CPSTF Recommendations on Community Health Worker Interventions:

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