Self-reported outcomes of a randomized trial comparing three community health worker interventions for diabetes prevention among Cambodian Americans with depression

• Published in: Patient education and counseling Vol. 105; no. 12; pp. 3501 - 3508
• Main Authors: Wagner, Julie, Bermúdez-Millán, Angela, Buckley, Thomas, Buxton, Orfeu M., Feinn, Richard, Kong, Sengly, Kuoch, Theanvy, Nye, Lindsay Master, Scully, Mary
• Format: Journal Article
• Language: English
• Published: Elsevier B.V 01.12.2022
• Subjects: Cambodian; Community health workers; Depression; Diabetes; Self reported outcomes; Trauma; Depression; Self reported outcomes; Diabetes; Community health workers; Trauma; Cambodian
• ISSN: 0738-3991; 1873-5134
• DOI: 10.1016/j.pec.2022.09.011

Cambodian Americans have complex, interrelated and persistent medical and mental health problems stemming from genocide and the social determinants of health. We examined changes in multiple domains of self-reported health outcomes from a diabetes prevention trial. Methods: Cambodian Americans with depression and high risk for diabetes (n = 188) were randomized to one of three community health worker interventions: lifestyle vs lifestyle plus medication therapy management vs social services. Assessments were at baseline, 12- and 15-months. Results: The typical participant was 55 years old, female, earned below $20,000 annually, and had 7 years of education. About one-third were taking antidepressant medication and over half had elevated depressive symptoms. Relative to social services, lifestyle and lifestyle plus medication therapy management were both similarly effective at increasing diabetes knowledge, nutrition habits, sleep quality and decreasing pain; 2) lifestyle alone was superior to social services for self-reported health; and, 3) all three groups showed improved anxiety and insomnia. There were no effects on physical activity or physical functioning. Conclusion: Community health worker interventions have multiple benefits beyond delaying diabetes. Practice Implications: Health promotion programs that are designed and delivered appropriately can impact even hard to reach and hard to treat groups. •Cambodian Americans have complex, interrelated, and persistent medical and mental health problems.•We compared 3 community health worker interventions. Each variously improved diabetes knowledge, nutrition habits, sleep quality, and pain. .•None of the three interventions improved physical activity or physical functioning.•Health promotion programs that are designed and delivered appropriately can impact multiple outcomes even among hard to reach and treat groups.