Integrating Community Health Workers to Improve Diabetes Prevention
Condition: Diabetes Mellitus
MeSH terms: Diabetes Mellitus
Study type: Interventional

Summary: 
      Cluster randomized trial to test the impact of peer health coaches on prediabetic patients.
      This study will test a scalable model of peer health coaching to address the millions of
      patients at risk for Diabetes Mellitus, using low cost, culturally congruent personnel to
      promote prevention of Diabetes Mellitus in patient-centered medical home (PCMH) practice.
    

Detailed description: 
      This population based trial aims to understand the impact of peer health interventions on
      panels of patients in a real clinic environment

      Investigators will conduct a cluster-randomized trial to test the impact of peer health
      coaches on prediabetic patients cared for by patient-centered medical home model (PCMH) teams
      to:

        1. Reduce the incidence of type 2 DM in pre-diabetic, PCMH patients;

        2. Promote weight loss among pre-diabetic patients;

        3. Increase patient activation levels, a measureable construct of engagement, efficacy,
           skills, and confidence in managing one's health, among pre-DM patients, resulting in:

             1. Improved secondary clinical outcomes: better glycemic and blood pressure control,
                and lower Framingham risk scores;

             2. Increased utilization of preventive services (e.g. MOVE!, TeleMOVE!, Healthy
                Lifestyles, etc);

             3. Improved health behaviors (e.g. making dietary and exercise changes); and

        4. Develop, implement and assess strategies to recruit, train, and integrate peer CHW
           health coaches within the PCMH model.

      This study will test a scalable model of peer health coaching to address the millions of
      patients at risk for Diabetes Mellitus (DM),using low cost, culturally congruent personnel to
      promote prevention of DM in PCMH practice.
    

Intervention name(s): CHW Training; Data Only
Intervention type(s): Behavioral; Behavioral
Intervention description(s): CHWs will be trained in DM concepts, motivational interviewing, brief action planning, and stages of behavior change. CHWs will participate in a 105- hour core competency training. CHWs will conduct mock telephone counseling calls with trained standardized patients to enhance skills, gain feedback and develop confidence in these techniques.
In addition to these training experiences, CHWs will have letter templates, motivational interviewing scripts, and protocols available for patient outreach to standardize and guide patient outreach .
The completion of the CHW training will be followed by a final examination of knowledge and evaluation of trial encounters with "mock" participants (consisting of research staff and advisory board members).
Individuals who do not pass will receive intensive remediation and be required to repeat the examination.
Community Health Worker Coaching Intervention.; The teams randomly allocated will not have access to Community Health Workers.
Allocation: Randomized
Intervention model: Factorial Assignment
Masking: None (Open Label)
Primary purpose: Supportive Care