CHWs have a huge evidence base showing their contribution to the improvement of diabetes management. Download our CHW Impact on Diabetes fact sheet and share how CHWs make an impact!
The Role of CHWs in Combating Diabetes
Community Health Workers (CHWs) are public health workers with strong connections to the communities they serve. Their close bonds with community members allow them to serve as liaisons between health/social services and the community, facilitating access to services and improving service delivery to better meet community needs.4 CHWs help patients navigate the healthcare system, communicate with providers, set goals, and make lifestyle changes.4
Through healthcare navigation assistance, community education, informal counseling, social support, advocacy and the promotion of healthy lifestyle habits such as healthy eating and exercise, CHWs help reduce the prevalence and impact of diabetes in the communities that they serve.5,6 Interventions by CHWs result in improved diabetes self-management5,6 including improved foot care,6 physical activity,6 appointment keeping,6 medication adherence,6 and healthcare utilization.6 Numerous studies have shown that patients who receive support and health education from CHWs experience improvements in HbAlc,5,6,7 blood pressure,6 and lipid levels.6 The positive effect of CHWs on diabetes has been documented in a variety contexts, including high-risk African-American and Latino communities.5,6
In its 2002 report, the Institute of Medicine (IOM) recommends expanding the use of CHWs, especially among racial and ethnic minorities and other underserved populations, to improve health outcomes and reduce healthcare disparities.8 The Patient Protection and Affordable Care Act similarly recognizes CHWs as valuable members of care teams, and allocates funds to support and expand CHW programming.9 More recently, the American Association of Diabetes Educators issued guidance on the role CHWs can play in diabetes management and prevention, stating that, “Training and empowering CHWs to deliver current, accurate, and evidence based information can do much to benefit self-care behaviors, problem solving skills, and optimal outcomes in people affected by diabetes in their communities.”10
CHWs Addressing Diabetes in Michigan
CHWs have a long history of addressing diabetes in Michigan. In collaboration with the REACH Detroit Partnership, CHWs have helped people with diabetes patients achieve significant improvements in disease management and blood sugar control since the program began in the 2000s.5 Primary care practices and health centers are now integrating CHWs into interdisciplinary care teams, providing individual and group patient support. CHWs in Spectrum Health’s Core Health Program, Michigan Pathways to Better Health, Linking Clinical Care to Community Supports, MI Care Team, and the Southeast Michigan Beacon Project, among others, work directly with patients with diabetes.
1 Centers for Disease Control and Prevention. Diabetes Public Health Resource web page. Retrieved from http://www.cdc.gov/diabetes/statistics/prev/national/figpersons.htm. Last updated December 1, 2015. Accessed February 20, 2017.
2 Centers for Disease Control and Prevention. Diabetes Report Card 2014. Retrieved from http://www.cdc.gov/diabetes/pdfs/library/diabetesreportcard2014.pdf. Published 2015. Accessed February 20, 2017.
3 National Institute of Diabetes and Digestive and Kidney Diseases. 4 steps to manage your diabetes for life. Retrieved from https://www.niddk.nih.gov/health-information/diabetes/manage-monitoring-diabetes. Accessed February 20, 2017.
4 American Public Health Association. Support for community health workers to increase health access and to reduce health disparities. 2014. Retrieved from https://www.apha.org/policies-and-advocacy/public-health-policy-statements/policy-database/2014/07/09/14/19/support-for-community-health-workers-to-increase-health-access-and-to-reduce-health-inequities. Accessed December 1, 2016.
5 Spencer M, Rosland A, Kieffer E, Sinco B, Palmisano G, Anderson M, Guzman JR, Heisler M. Effectiveness of a community health worker intervention among African American and Latino adults with type 2 diabetes: a randomized controlled trial. Am J Public Health. 2011;101(12): 2253-2260.
6 Hunt CW, Grant JS, Appel SJ. An integrative review of community health advisors in type 2 diabetes. J Community Health. 2011;36:883.
7 Palmas W, March D, Darakjy S, et al. Community health worker interventions to improve glycemic control in people with diabetes: a systematic review and meta-analysis. J Gen Intern Med. 2015;30(7):1004-1012.
8 Smedley BD, Stith AY, Nelson AR, eds. Unequal treatment: confronting racial and ethnic disparities in health care. Washington, DC:Institute of Medicine;2002:17-18.
9 The Patient Protection and Affordable Care Act. U.S. Government Printing Office website. https://www.gpo.gov//fdsys/pkg/PLAW-111publ148/html/PLAW-111publ148.htm. Accessed December 1, 2016.
10 American Association of Diabetes Educators. Community Health Workers in Diabetes Management and Prevention. Retrieved from https://www.diabeteseducator.org/docs/default-source/default-document-library/community-health-workers-in-diabetes-management-and-prevention.pdf?sfvrsn=0. Last updated June 4, 2015. Accessed April 2, 2017.
In partnership with the Michigan Department of Health & Human Services and the Centers for Disease Control and Prevention, MiCHWA compiled resources that illustrate the vital role CHWs play in preventing, controlling, and managing chronic disease.