Date of Award

Spring 5-2022

Document Type

DNP Project

Project Team Faculty Member

Amy Hamilton, DNP

Project Team Faculty Member

Amelia Pérez, PhD, RN

Keywords

community health worker, type 2 diabetes, primary care, diabetic management, self-management, hemoglobin a1c

Abstract

Type 2 Diabetes Mellitus (T2DM) is a disease that disproportionally impacts patients with multiple socioeconomic barriers that are often difficult to address during a primary care visit. Several provider and practice-level barriers also exist including time limitations within the visit and lack of trained staff to help with patient education and case management. Uncontrolled T2DM leads to poor health outcomes and increased healthcare costs. Community Health Workers (CHW) are trained lay persons that can successfully address the patient’s unmet needs and assist with the provider’s recommendations. The purpose of this project was to explore if a CHW led intervention focused on improving diabetic management would decrease the hemoglobin a1c (HbA1c) of adult primary care patients with uncontrolled T2DM in a Community Health Center (CHC). Participating patients received diabetic and self-management education as well as care coordination if needed at least twice during the project. There were several limitations related to the pandemic that impacted participation including staffing, rescheduling of patients, dependence on phone communications, and initial engagement amongst providers. Results from 18 uncontrolled diabetics who received CHWs services showed a decrease in the average HbA1c by 3.04% over a 3-month period. The patient’s benefited by an approval in their HbA1c and the CHC was able to meet their strategic goal to improve HbA1c across the system. Without an additional financial burden to the organization, the proven benefits of the CHW led intervention was shown to be an effective and sustainable program within the CHC.

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Literature Review Wojtko.pdf (121 kB)
Literature Review

Conceptual Framework Wojtko.pdf (75 kB)
Conceptual Framework

Project Methods Wojtko.pdf (87 kB)
Project Methods

Evaluation Process Wojtko.pdf (75 kB)
Evaluation Process

Final Reference List Wojtko.pdf (101 kB)
Final Reference List

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