A Patient-Centered Approach Using Community-Based Paraprofessionals to Improve Self-Management of Type 2 Diabetes

Background

Type 2 diabetes is a serious epidemic in our society, which can be prevented or controlled through proper self-management behaviors. Community-based paraprofessionals can serve an important role in forming alliances between health care professionals and patients to enhance self-management practices and improve health outcomes.

Purpose

The purpose of this study was to examine the impact of a 10-week lifestyle management program delivered by community-based paraprofessionals in improving clinical markers and dietary behaviors related to diabetes control in an underserved population.

Methods

Michigan State University Extension county offices partnered with local health clinics to identify and recruit participants with physician-identified type 2 diabetes. A research assistant at each clinic introduced the program, obtained consent, and collected baseline and follow-up clinical data (blood pressure, body mass index [BMI], and HbA1c), demographic information, and an assessment of lifestyle behaviors.

Results

Paired t tests indicated significant changes for: HbA1c (P < .001), BMI (P < .05), smoking tobacco (P < .05), fruit and vegetable intake (P < .01), and appraisal of diabetes scores (P < .001).

Discussion

These results demonstrate the potential of programs delivered by trained community-based paraprofessionals to improve health outcomes in adults with type 2 diabetes.

Translation to Health Education Practice

The findings suggest ways in which community organizations can design programs, delivered by trained paraprofessionals, to help address the growing issue of type 2 diabetes.

Acknowledgments

The authors gratefully acknowledge the contributions of the MSU-E paraprofessionals in each of the counties and their supervisors. We also thank MSU-E Program Leader Kathy Majewski, MS, RD, for providing exceptional campus support for the project.