A Culturally Adapted, Telehealth, Community Health Worker Intervention on Blood Pressure Control among South Asian Immigrants with Type II Diabetes: Results from the DREAM Atlanta Intervention

Background South Asians face a high prevalence of type II diabetes (DMII) and comorbid hypertension (HTN). Community health worker (CHW) interventions have the potential to improve chronic disease outcomes, yet few have been tailored to South Asian populations in the United States. Objective To test...

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Bibliographic Details
Published in:Journal of general internal medicine : JGIM 2024-03, Vol.39 (4), p.529-539
Main Authors: Shah, Megha K., Wyatt, Laura C., Gibbs-Tewary, Christina, Zanowiak, Jennifer M., Mammen, Shinu, Islam, Nadia
Format: Article
Language:English
Subjects:
Adult
Adults
Asian Americans
Blood Pressure
Chronic illnesses
Community Health Workers
Comorbidity
Diabetes
Diabetes mellitus
Diabetes Mellitus, Type 2 - therapy
Education
Emigrants and Immigrants
Feasibility
Hemoglobin
Humans
Hypertension
Hypertension - therapy
Internal Medicine
Intervention
Medical personnel
Medicine
Medicine & Public Health
Original Research
South Asian People
Telemedicine
Weight
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Summary:Background South Asians face a high prevalence of type II diabetes (DMII) and comorbid hypertension (HTN). Community health worker (CHW) interventions have the potential to improve chronic disease outcomes, yet few have been tailored to South Asian populations in the United States. Objective To test the effectiveness of an evidence-based CHW-led and culturally-tailored HTN and DMII management program for South Asian adults with diabetes and comorbid uncontrolled HTN (systolic blood pressure (SBP) > 130 mmHg or diastolic blood pressure (DBP) > 80 mmHg). Design Randomized-controlled Trial. Participants South Asian adults with DMII and comorbid HTN. Intervention The Diabetes Research, Education, and Action for Minorities (DREAM) Atlanta intervention was a CHW telehealth intervention designed to improve blood pressure (BP). The treatment group received five virtual group-based health education sessions, an action plan, and follow-up calls to assess goal setting activities. The control group received only the first session. Main Measures included: feasibility, improvement in BP control, and decreases in SBP, DBP, weight, and hemoglobin A1c (HbA1c). Key Results A total of 190 South Asian adults were randomized (97 to the treatment group and 93 to the control group); 94% of treatment group participants completed all 5 telehealth sessions. At endpoint, BP control increased 33.7% (95% CI: 22.5, 44.9, p 
ISSN:0884-8734
1525-1497
DOI:10.1007/s11606-023-08443-6