Hispanics in the USA are affected by the diabetes epidemic disproportionately, and they consistently have lower access to care, poorer control of the disease and higher risk of complications. This study evaluates whether a community health worker (CHW) intervention may improve clinically relevant markers of diabetes care in adult underserved Hispanics.
Methods and analysis
The Northern Manhattan Diabetes Community Outreach Project (NOCHOP) is a two-armed randomised controlled trial to be performed as a community-based participatory research study performed in a Primary Care Setting in Northern Manhattan (New York City). 360 Hispanic adults with poorly controlled type 2 diabetes mellitus (haemoglobin A1c >8%), aged 35–70 years, will be randomised at a 1:1 ratio, within Primary Care Provider clusters. The two study arms are (1) a 12-month CHW intervention and (2) enhanced usual care (educational materials mailed at 4-month intervals, preceded by phone calls). The end points, assessed after 12 months, are primary = haemoglobin A1c and secondary = blood pressure and low-density lipoprotein-cholesterol levels. In addition, the study will describe the CHW intervention in terms of components and intensity and will assess its effects on (1) medication adherence, (2) medication intensification, (3) diet and (4) physical activity.
Ethics and dissemination
All participants will provide informed consent; the study protocol has been approved by the Institutional Review Board of Columbia University Medical Center. CHW interventions hold great promise in improving the well-being of minority populations who suffer from diabetes mellitus. The NOCHOP study will provide valuable information about the efficacy of those interventions vis-à-vis clinically relevant end points and will inform policy makers through a detailed characterisation of the programme and its effects.
Clinical trial registration number
NCT00787475 at clinicaltrials.gov.
Randomised controlled trial.
This community-based participatory research study is a collaboration between a community organisation and a university in Northern Manhattan, New York City.
The goal is to assess whether the CHW worker intervention may improve diabetes care in underserved adult Hispanics from the community.
The primary outcome of interest is haemoglobin A1c, a marker of diabetes control; secondary outcomes are blood pressure and low-density lipoprotein cholesterol levels.
Strengths and limitations of this study
This study will examine effects of the CHW intervention after 12 months, a longer time period than in previous studies.
The CHW intervention protocol was developed in a culturally appropriate manner to address the needs of Hispanics residing in our community.
If proven efficacious, it will warrant examination in other cultural socioeconomic milieus.