A Project ECHO and Community Health Worker Intervention for Patients with Diabetes.

Area of Science:

• Primary Care
• Diabetes Management
• Health Services Research

Background:

• Community health workers and Project ECHO telementoring are innovative models for complex patient care.
• Primary care providers (PCPs) face challenges in managing patients with diabetes.
• This study investigates a combined intervention to support PCPs in diabetes care.

Purpose of the Study:

• To evaluate the impact of a combined intervention using community health workers and Project ECHO on glycemic control in patients with diabetes.
• To assess changes in Hemoglobin A1c (HbA1c) levels at early (3 months) and late (12 months) follow-up.

Main Methods:

• A cohort of 557 patients with diabetes was recruited from federally qualified health centers.
• Electronic health record (EHR) data were used to compare HbA1c levels pre-intervention and post-intervention.
• Propensity matching was employed to compare intervention patients with a control group from similar EHR databases.

Main Results:

• Mean HbA1c decreased from 10.5% to 9.3% in intervention patients (P < .001).
• The intervention showed a trend towards improved glycemic control at late follow-up (-0.3% change in HbA1c).
• A significant increase in patients achieving HbA1c <8% was observed at late follow-up (8.1%).

Conclusions:

• The combined intervention demonstrated a substantial decrease in HbA1c among participating patients.
• While promising for long-term glycemic control, the intervention's early impact was not significantly different from the comparison group.
• Further research is needed to fully establish the efficacy of integrating community health workers with Project ECHO for diabetes management.