Applying the community health worker model to diabetes management: using mixed methods to assess implementation and effectiveness

Abstract

INTRODUCTION: The community health worker (CHW) model is a popular method for reaching vulnerable populations with diabetes. This study assessed implementation and effectiveness of the model within diabetes programs. METHODS: Four databases were searched to identify diabetes programs implementing the CHW model. Corresponding articles were reviewed and semi-structured interviews were conducted with directors of each program. RESULTS: Eight studies met inclusion criteria for review and their program managers were interviewed. Five CHW roles were identified: educator, case manager, role model, program facilitator, and advocate. Roles, responsibilities and training varied greatly across programs. Selected outcomes also varied, ranging from physiologic measures, to health behaviors, to measures of health care utilization and cost. CONCLUSIONS: Research regarding application of the community health worker model in diabetes management is limited and consensus regarding the scope of the CHW's role is lacking. Future studies should rigorously examine how best to integrate this promising model into chronic disease management.