Evidence mapPaperPMID 36446462Full record

ArticleBMJ open2022

Participant engagement in a community health worker-delivered intervention and type 2 diabetes clinical outcomes: a quasiexperimental study in MexicanAmericans.

Belinda M Reininger, Juliana Lopez, Maria Zolezzi, MinJae Lee, Lisa A Mitchell-Bennett, Tianlin Xu, Soo Kyung Park, Mayra V Saldana, LuBeth Perez, Lisa Y Payne and 2 more

Open access · goldAbstract read
In one paragraph

Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
1.1field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 8 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 3 institutions in 1 country.

Belinda M ReiningerSchool of Public Health, Brownsville Regional Campus, The University of Texas Health Science Center at Houston, Brownsville, Texas, USA.ORCID 0000-0003-4446-9735
Juliana LopezSchool of Public Health, Brownsville Regional Campus, The University of Texas Health Science Center at Houston, Brownsville, Texas, USA.
Maria ZolezziSchool of Public Health, Brownsville Regional Campus, The University of Texas Health Science Center at Houston, Brownsville, Texas, USA maria.e.zolezzi@uth.tmc.edu.ORCID 0000-0003-4783-0872
MinJae LeeDivision of Biostatistics, Department of Population and Data Sciences, The University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Lisa A Mitchell-BennettSchool of Public Health, Brownsville Regional Campus, The University of Texas Health Science Center at Houston, Brownsville, Texas, USA.
Tianlin XuBiostatistics, University of Texas School of Public Health, Houston, Texas, USA.ORCID 0000-0002-5699-5540
Soo Kyung ParkDepartment of Biostatistics and Data Sciences, The University of Texas Health Science Center at Houston, Houston, Texas, USA.
Mayra V SaldanaSchool of Public Health, Brownsville Regional Campus, The University of Texas Health Science Center at Houston, Brownsville, Texas, USA.
LuBeth PerezSchool of Public Health, Brownsville Regional Campus, The University of Texas Health Science Center at Houston, Brownsville, Texas, USA.
Lisa Y PayneSchool of Public Health, The University of Texas Health Science Center at Houston, Brownsville, Texas, USA.
Cindy CollierPublic Health College of Nursing and Health Sciences, Texas A&M International University, Laredo, Texas, USA.
Joseph B McCormickSchool of Public Health, Brownsville Regional Campus, The University of Texas Health Science Center at Houston, Brownsville, Texas, USA.
The University of Texas Health Science Center at Houston · USTexas A&M International University · USThe University of Texas Southwestern Medical Center · US

Funding

NCATS NIH HHS UL1 TR003167
6 · The paper itself

Abstract

objectivesThis study helps to fill the existing research gap related to participant engagement in behavioural interventions and diabetes management. We examined type 2 diabetes control over time among Mexican Americans by level of engagement in a chronic care management (CCM) program that included community health worker (CHW)-delivered multilevel interventions. The programme complemented clinical care and promoted behaviour changes to improve diabetes self-management.

designQuasiexperimental study.

settingThe study was implemented in the Rio Grande Valley region in the USA. Recruitment was conducted in clinics and community events. All other visits were provided in participant homes and community locations.

participants5649 adults (aged ≥18 years) with poorly controlled type 2 diabetes who enrolled in a community-delivered CCM programme between September 2013 and 2018.

interventionsThe intervention comprised two components: CHW home visits conducted every 3 months and diabetes self-management education (DSME) classes provided in community locations. PRIMARY OUTCOME MEASURES: The primary outcome was haemoglobin A1c (HbA1c) measured at baseline every 3 months for up to 24 months. We first examined changes in HbA1c levels over time. The number of completed CHW and DSME encounters was used to classify participants into engagement groups-high engagement defined as ≥10 encounters (n=2952); low engagement defined as 1-9 encounters (n=2697). We used univariable and multivariable longitudinal linear regression models with a generalised estimating equation method. We tested interactions between engagement groups and time.

resultsParticipants' mean HbA1c decreased from 10.20% at baseline to 8.93% (p<0.0001) at 3 months, remaining stable thereafter. Changes in HbA1c were statistically different between the engagement groups. High engagement participants had lower HbA1c levels over the first 15 months of the follow-up period compared with low engagement participants, as compared at 3 months (-0.44%, 95% CI -0.57% to -0.31%; p<0.0001), 6 months (-0.31%, 95% CI -0.43% to -0.14%; p<0.0001), 9 months (-0.27%, 95% CI -0.42% to -0.13%; p=0.0001), 12 months (-0.23%, 95% CI -0.37% to -0.08%; p=0.0025) and 15 months (-0.32%, 95% CI -0.54% to -0.10%; p=0.0040). At months 18, 21 and 24, the HbA1c differences were not statistically significant (18 months: -0.34%, 95% CI -0.77% to 0.08%; p=0.1086; 21 months: -0.22%, 95% CI -1.00% to 0.56%; p=0.5721; 24 months: -0.42%, 95% CI -1.38% to 0.55%; p=0.3966).

conclusionsHigher engagement in the CCM programme delivered by CHWs and coordinated with clinical care was associated with beneficial improvements in type 2 diabetes control, but both engagement groups showed strong improvements.

Indexed as

Autoimmune DiseasesDiabetes Mellitus, Type 2AdolescentAdultCommunity Health WorkersGlycated HemoglobinHealth BehaviorHumansMexican AmericansGlycated HemoglobinDIABETES & ENDOCRINOLOGYEPIDEMIOLOGYPUBLIC HEALTH

Identifiers

PMID36446462
PMCPMC9710373
OpenAlexW4310360063

What Socratic holds

Textmetadata
LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.