Tools and Practices to Reduce CVD and Complications in the Diabetic Population

Background

This 5-year research project focused on the prevention of cardiovascular disease (CVD) and its complications among adults with diabetes who use public health services in Sonora, Mexico.

Aims

One major component of the study aimed to assess the effectiveness of an adapted evidence-based community health worker intervention, Meta Salud Diabetes, a 13-week intervention to reducing behavioral and clinical risk for cardiovascular disease among adults with diabetes. The second component was an implementation study that consisted of systematic engagement of local, state and national decision makers essential to scale up and sustain the intervention into the standard package of services offered by government-run health centers in Sonora and other Mexican states.

Project plan

For the first component of the study we aimed to conduct a cluster-randomized trial among adult patients with diabetes sampled from 20 Secretaría de Salud (Secretary of Health)-operated health centers in Sonora. Community health workers and other personnel at each of ten health centers randomized to the intervention condition were trained in the adapted CVD prevention curriculum. The health center personnel then aimed to enroll 20 participants with diabetes at each site into the 13-week intervention. Clinical risk factors (i.e., BMI, blood pressure, lipids, blood sugar), psychosocial (e.g., knowledge, attitudes, and beliefs) and behavioral (e.g., smoking, healthy eating) risk factors for cardiovascular disease were assessed via tests and a survey during the first of the 13 weekly educational sessions. We aimed to assess changes that occurred at three months (immediately after the intervention) and 12 months. Changes in the intervention sites would then be compared to changes over the same time period among adult patients with diabetes in each of ten health centers randomized to the control condition. For the second component of the study, extensive qualitative and descriptive data was collected on the facilitators and barriers to adopt and integrate community health worker chronic disease interventions in Sonoran health centers and throughout Mexico.

Impact

The Meta Salud Diabetes project developed a Certificate in Health Promotion, supported by the health sector in Mexico, which provided scholarships for 15 health personnel. Work is ongoing to integrate the Meta Salud Diabetes approach into the national health promotion programme.

Publications and output

GACD have also published an end-of-programme report, providing a comprehensive summary of the programme and outcomes.

This project has a related case study A community health worker intervention to reduce cardiovascular disease and complications in the diabetic population of Mexico.

Principal investigators

Funding organisations

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