The Impact of Community Health Worker Interventions on A1C in People of Racial/Ethnic Minority Groups with Type 2 Diabetes: A Systematic Review and Meta-analysis

Objective: Communities of racial/ethnic minority groups experience a higher prevalence of type 2 diabetes (T2DM) with higher rates of diabetes-related complications compared to non-Hispanic Whites. Interventions that utilize community health workers (CHW) are often successful at improving glycemic control. This analysis aimed to examine the effectiveness of CHW interventions on glycemic control in people of racial/ethnic minority groups with T2DM. Methods: A search of electronic databases (PubMed, Scopus, CINAHL, PsycInfo) to identify articles published between 1985 and 20was conducted using broad search terms for diabetes, race/ethnicity, and disparities. To further refine articles to those focusing on CHW-based randomized controlled trials, abstracts were searched for “community workers” and “promotores.” A random effects model was used to calculate the effect of CHW interventions on hemoglobin A1c (HbA1c) with future plans to analyze effects on other cardiovascular risk factors such as body mass index, blood pressure, and cholesterol. Results: A total of 22 RCTs were identified, involving 4996 adults (26% Black, 50% Hispanic, 11% Asian, and 11% Pacific Islander) . CHW interventions among people of racial/ethnic minority groups was associated with a 0.44% (95% confidence interval: -0.56% to -0.31%; p<0.0001) reduction in HbA1c. Conclusion: CHW interventions are an effective means to lower HbA1c among people of racial/ethnic minority groups with T2DM. This finding is important for future healthcare policies, which should work to emphasize culturally sensitive interventions for patients with T2DM while maintaining cost effectiveness through CHWs. Future research should examine the effectiveness of CHWs for diabetes prevention. Disclosure R.Shetty: None. A.Deckard: None. W.Wan: n/a. A.Nathan: None. E.M.Staab: None. A.W.Rodriguez: None. A.Gandhi: None. A.A.Baig: None. N.Laiteerapong: None.