ArticleJournal of general internal medicine2026
Feasibility of a Church-Based, CHW-Delivered Diabetes and SDOH Intervention in a Hispanic Community: A Quasi-Experimental Study.
Article in Journal of general internal medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundSocial determinants of health (SDOH) screenings have identified disproportionate inequities in Hispanic populations that increase diabetes risk, yet they rarely lead to interventions. Churches are trusted community hubs with the potential to address health needs; however, partnerships with Hispanic churches remain largely unexplored.
objectiveTo assess the feasibility of a church-based, community health worker (CHW)-led program to identify and address SDOH inequities in a Hispanic community.
designPilot quasi-experimental feasibility study
participantsForty-seven Hispanic adults, predominantly women (74.5%), with a mean age of 51 years
interventionsFive church congregants obtained CHW state certification (160-h course) and received training in teaching skills, diabetes self-management, and SDOH. With ongoing mentoring, CHWs led a 6-month diabetes prevention and self-management program with monthly in-person education and weekly mHealth coaching focused on addressing SDOH inequities in the healthcare access and quality domain. MAIN MEASURES: Feasibility was assessed across eight pre-established variables (integration, expansion, demand, implementation, limited efficacy, acceptability, practicality, and adaptation), including CHWs' ability to address SDOH inequities such as insurance coverage, established medical home, primary care utilization, eye exams, medication access, and glucose monitoring. KEY
resultsCHWs completed 97.3% of planned weekly mHealth contacts, identified and addressed 92.8% of participant concerns, and conducted all in-person education sessions per protocol. Healthcare access improved significantly: insurance coverage/clinic eligibility (66.0 to 85.1%; p = 0.025), established medical home (61.7 to 91.5%; p < 0.0001), time since last primary care visit (16.2 to 1.4 months; p = 0.017), and annual eye exams (25.0 to 64.3%; p < 0.0001). On a 5-point Likert scale, participants increased access to medications (Δ = 0.54; p = 0.03), medical care (Δ = 0.67; p = 0.012), and a primary care provider (Δ = 0.79; p = 0.009). Among participants with diabetes, glucose monitoring increased from 0.5 to 1.4 times daily (p = 0.017).
conclusionsFindings support the feasibility of partnering with Hispanic churches to both identify and address healthcare access SDOH inequities.
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