CHWs have a huge evidence base showing their contribution to preventing diabetes. Download our CHW Impact on Prediabetes fact sheet and share how CHWs make an impact!
The Role of CHWs in Combating Prediabetes
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.3 CHWs help patients navigate the healthcare system, communicate with providers, set goals, and adhere to lifestyle changes through meetings and home visits.3 Their deep community understanding uniquely positions CHWs to provide relevant education to their communities regarding diabetes prevention and control. CHWs also help prevent or delay the onset of diabetes through the promotion of healthy lifestyle changes by serving as lifestyle coaches for those at high risk.3
Innovative strategies are necessary to reach the 86 million people with prediabetes in the US. Promising research has shown that incorporating CHWs into translations of the national Diabetes Prevention Program (DPP) lifestyle interventions can result in significant reductions in blood glucose and insulin levels, insulin resistance, weight and waist circumference for community members with prediabetes.4 Improvements in BMI, waist circumference and body fat, and dietary outcomes were seen in Latinos with prediabetes or obesity.5 By promoting community education on nutrition, physical activity, weight management, and by providing social support, CHWs can augment existing programs that serve to help patients with prediabetes manage their health.4
CHWs have demonstrated the potential to be effective members of care teams, promoting other aspects of patient health, such as increased diabetes knowledge, medication adherence, and self-care behavior.6 In its 2009 Position Statement on Community Health Workers in Diabetes Management and Prevention, the American Association of Diabetes Educators (AADE) supported the role of CHWs in serving to bridge the gap between the health care system and people with and at risk for diabetes, particularly in underserved communities.7 In 2015, the AADE further recommended that diabetes educators acknowledge and support the role of the CHW in primary and secondary diabetes prevention.8 The Community Preventive Services Task Force recommends engaging CHWs in diabetes prevention, including with DPP classes.9
CHWs Addressing Prediabetes in Michigan
The Diabetes Prevention and Control Program (DPCP) at the Michigan Department of Health and Human Services (MDHHS) has recently been engaging CHWs to work with local health care providers to establish systems to identify patients with prediabetes and refer to DPCP and other community resources.10 Many agencies employ CHWs to lead DPP classes, too, including the National Kidney Foundation of Michigan. And MiCHWA continues to work to integrate CHWs into Michigan’s health and human service systems so they can better support individuals with prediabetes and their communities.
1 Ghody P, Shikha D, Karam J, Bahtiyar G.Identifying prediabetes – Is it beneficial in the long run? Maturitas. 2015;81(2):282-286.
2 What is Pre-diabetes? Pre-Diabetes Information | Joslin Diabetes Center. http://www.joslin.org/info/what_is_pre_diabetes.html. Accessed December 12, 2016.
3 Centers for Disease Control. Addressing chronic disease through community health workers. Retrieved from https://www.cdc.gov/dhdsp/docs/chw_brief.pdf. Published April 2015. Accessed December 20, 2016.
4 Katula JA, Vitolins MZ, Rosenberger EL, et al. One-year results of a community-based translation of the diabetes prevention program: Healthy-Living Partnerships to Prevent Diabetes (HELP PD) project. Diabetes Care. 2011;34(7):1451-1457.
5 Ruggiero L, Oros S, Choi YK. Community-based translation of the Diabetes Prevention Program’s lifestyle intervention in an underserved Latino population. The Diabetes Educator. 2011;37(4):564-572.
6 Ruggiero L, Castillo A, Quinn L, Hochwert M. Translation of the Diabetes Prevention Program’s lifestyle intervention: role of community health workers. Current diabetes reports. 2012;12(2):127-137.
7 American Association of Diabetes Educators. AADE position statement: community health workers in diabetes management and prevention. Diabetes Educ. 2009;35:48S–52S.
8 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.
9 Community Preventive Services Task Force. Diabetes prevention: interventions engaging community health workers. Retrieved from https://www.thecommunityguide.org/sites/default/files/assets/Diabetes-Prevention-Community-Health-Workers.pdf. Last updated January 25, 2017. Retrieved April 2, 2017.
10 Michigan Department of Health and Human Services: Diabetes Prevention and Control Program (DPCP). Michigan Diabetes Partners in Action Coalition. Retrieved from http://dpacmi.org/documents/DPCP-Update-9-9-15.pdf. Published November 6, 2015. Accessed December 13, 2016.
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.