TY - JOUR AU - Nelson, Karin AU - Taylor, Leslie AU - Silverman, Julie AU - Kiefer, Meghan AU - Hebert, Paul AU - Lessler, Dan PY - 2017 TI - Randomized Controlled Trial of a Community Health Worker Self-Management Support Intervention Among Low-Income Adults With Diabetes, Seattle, Washington, 2010-2014 T2 - Preventing Chronic Disease JO - Prev Chronic Dis SP - E15 VL - 14 CY - Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. N2 - INTRODUCTION Community health workers (CHWs) can improve diabetes outcomes; however, questions remain about translating research findings into practical low-intensity models for safety-net providers. We tested the effectiveness of a home-based low-intensity CHW intervention for improving health outcomes among low-income adults with diabetes. METHODS Low-income patients with glycated hemoglobin A1c (HbA1c) of 8.0% or higher in the 12 months before enrollment from 3 safety-net providers were randomized to a 12-month CHW-delivered diabetes self-management intervention or usual care. CHWs were based at a local health department. The primary outcome was change in HbA1c from baseline enrollment to 12 months; secondary outcomes included blood pressure and lipid levels, quality of life, and health care use. RESULTS The change in HbA1c in the intervention group (n = 145) (unadjusted mean of 9.09% to 8.58%, change of -0.51) compared with the control group (n = 142) (9.04% to 8.71%, change of -0.33) was not significant (P = .54). In an analysis of participants with poor glycemic control (HbA1c >10%), the intervention group had a 1.23-point greater decrease in HbA1c compared with controls (P = .046). For the entire study population, we found a decrease in reported physician visits (P < .001) and no improvement in health-related quality of life (P = .07) in the intervention group compared with the control group. CONCLUSION A low-intensity CHW-delivered intervention to support diabetes self-management did not significantly improve HbA1c relative to usual care. Among the subgroup of participants with poor glycemic control (HbA1c >10% at baseline), the intervention was effective. SN - 1545-1151 UR - https://doi.org/10.5888/pcd14.160344 DO - 10.5888/pcd14.160344 ER -