• J Gen Intern Med · Mar 2024

    Randomized Controlled Trial

    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.

    • Megha K Shah, Laura C Wyatt, Christina Gibbs-Tewary, Jennifer M Zanowiak, Shinu Mammen, and Nadia Islam.
    • Department of Family and Preventive Medicine, Emory University School of Medicine, Atlanta, GA, USA. mkshah@emory.edu.
    • J Gen Intern Med. 2024 Mar 1; 39 (4): 529539529-539.

    BackgroundSouth 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.ObjectiveTo 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).DesignRandomized-controlled Trial.ParticipantsSouth Asian adults with DMII and comorbid HTN.InterventionThe 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 ResultsA 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 < 0.001) in the treatment group and 16.5% (95%: 6.2, 26.8, p = 0.003) in the control group; the adjusted intervention effect was 1.8 (95% CI: 1.0, 3.2, p = 0.055). Mean weight decreased by 4.8 pounds (95% CI: -8.2, -1.4, p = 0.006) in the treatment group, and the adjusted intervention effect was -5.2 (95% CI: -9.0, -1.4, p = 0.007. The intervention had an overall retention of 95%.ConclusionsA culturally-tailored, CHW-led telehealth intervention is feasible and can improve BP control among South Asian Americans with DMII.Gov RegistrationNCT04263311.© 2023. The Author(s), under exclusive licence to Society of General Internal Medicine.

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