Evidence mapPaperPMID 42258200Full record

Trial reportJAMA internal medicine2026

Structured Telehealth Community Health Worker-Clinician Feedback and Diabetes Outcomes: A Randomized Clinical Trial.

Elizabeth M Vaughan, Xiaoying Yu, Amber B Amspoker, Aanand D Naik, Ashok Balasubramanyam, Craig A Johnston, Christi M Ballantyne, Salim S Virani, H Shelton Brown, Kristina Mena and 1 more

Registry-linked trialAbstract readRandomized Controlled TrialMulticenter Study
In one paragraph

Trial report in JAMA internal medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04835493 (Evaluating Telementoring to Initiate a Multidimensional Diabetes Program for Latino), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
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.

NCT04835493 naactive not recruitingnot on this map

Evaluating Telementoring to Initiate a Multidimensional Diabetes Program for Latino(a)s in Community Clinics: A Randomized Clinical Trial

TypeinterventionalSponsorThe University of Texas Medical Branch, GalvestonRan2022 to 2028Enrolled320ConditionsDiabetes Mellitus, Type 2ArmsIntervention
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

11 authors.

Elizabeth M VaughanDepartment of Internal Medicine, University of Texas Medical Branch, Galveston.
Xiaoying YuDepartment of Biostatistics & Data Science, University of Texas Medical Branch, Galveston.
Amber B AmspokerDepartment of Medicine, Baylor College of Medicine, Houston, Texas.
Aanand D NaikDepartment of Management, Policy, and Community Health, UT Health Houston School of Public Health, Houston, Texas.
Ashok BalasubramanyamDepartment of Medicine, Baylor College of Medicine, Houston, Texas.
Craig A JohnstonDepartment of Health and Human Performance, University of Houston, Houston, Texas.
Christi M BallantyneDepartment of Medicine, Baylor College of Medicine, Houston, Texas.
Salim S ViraniSection of Cardiology, Department of Medicine, Aga Khan University, Karachi, Pakistan.
H Shelton BrownDepartment of Management, Policy, and Community Health, UT Health Houston School of Public Health, Houston, Texas.
Kristina MenaDepartment of Environmental and Occupational Health Sciences, University of Texas School of Public Health, El Paso.
Laura R PorterfieldDepartment of Family Medicine, University of Texas Medical Branch, Galveston.

Funding

Evaluating telementoring to initiate a multidimensional diabetes program for Latino(a)s in community clinics: A Randomized Clinical TrialR01DK129474 · UNIVERSITY OF TEXAS MED BR GALVESTON · 2025 to 2025
$573k
NIDDK NIH HHS R01 DK129474
6 · The paper itself

Abstract

Importance: Community health workers (CHWs) improve chronic disease management in underserved populations, but scalable integration strategies are limited. Objective: To evaluate whether a multidimensional intervention incorporating telementored CHWs and a structured participant-CHW-clinician feedback loop can improve diabetes outcomes. Design, Setting, and Participants: This 12-month randomized clinical trial was conducted at 3 institutionally and geographically diverse community clinics in Texas between September 1, 2023, and April 30, 2025, and included low-income, uninsured White Hispanic adults with type 2 diabetes identified through clinic databases. Data were analyzed between May 1 and July 31, 2025. Intervention: Individuals were randomized 1:1 to the intervention or control. For the intervention, CHWs delivered (1) group diabetes education, (2) individualized telehealth-based coaching, and (3) a novel participant-CHW-clinician feedback loop to facilitate communication, address participant concerns, and improve care coordination. The control was usual care (quarterly clinician visits and access to multidisciplinary and social services). Main Outcomes and Measures: The primary outcome was baseline to 12-month change in hemoglobin A1c (HbA1c) level. Secondary outcomes included changes in cholesterol levels, American Diabetes Association (ADA) guideline adherence, participant recruitment, intervention fidelity, and feedback loop issue resolution. Results: Of 257 participants included in the intention-to-treat analysis (mean [SD] age 54 [11] years; 166 [64.6%] female), 129 were in the intervention group and 128 were in the control group. The intervention reduced HbA1c (net difference, -1.0 [95% CI, -1.5 to -0.4] percentage points [pp]; P = .001), total cholesterol (net difference, -35.4 mg/dL; 95% CI, -54.6 to -17.2 mg/dL; P = .02), and low-density lipoprotein cholesterol (net difference, -29.7 mg/dL; 95% CI, -44.5 to -14.9 mg/dL; P < .001) levels compared with control. ADA guideline adherence improved for foot examinations (absolute risk [AR], 19.2 [95% CI, 7.4-30.9] pp; relative risk [RR], 1.65 [95% CI, 1.19-2.27]; P = .03) and urine microalbumin screening (AR, 15.8 [95% CI, 5.3-26.3] pp; RR, 1.24 [95% CI, 1.07-1.43]; P = .048). CHWs addressed 490 participant concerns (87.2%) via the feedback loop, including medication refills, glucose management, and access to care. Conclusions and Relevance: In this randomized clinical trial, the CHW intervention significantly improved diabetes outcomes in low-income settings, potentially by reducing fragmentation through structured feedback. Findings also highlight limitations in usual care, underscoring the need for scalable strategies to strengthen chronic disease management in low-income populations. Trial Registration: ClinicalTrials.gov Identifier: NCT04835493.

Indexed as

Community Health WorkersDiabetes Mellitus, Type 2TelemedicineAdherence InterventionsAdultDigital HealthFemaleGlycated HemoglobinHumansMaleMiddle AgedPatient Education as TopicTexasGlycated Hemoglobin

Identifiers

PMID42258200
PMCPMC13247847

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

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.