Data curation, Background. Establishing acceptable standards for health care for people with diabetes. Click through the PLOS taxonomy to find articles in your field. As noted by Davis et al (2007), improvements in diabetic control following CHW self-management education intervention begins to decline six months after the end of intervention, [15,43,76] and lifetime follow-up and support may be required[78], especially in settings where there is a lack of professional health care providers. CHWs play several roles in T2DM self-management, including structured education, ongoing support and health system advocacy. The proactive model that was used for preventing diabetes mellitus was a health promotion program. Fig 1. They will need on-going advice and support about maintaining a healthy diet, keeping active and monitoring their condition. This role and associated responsibilities will be specified in local workplace guidance and policies and by each member of the nursing team's level of competence. Najafizada SA, Bourgeault IL, Labonte R, Packer C, Torres S. Can J Public Health. Ideal diabetes management places nurse practitioners (NPs) at the center of a team of clinicians, each with an equally important role to play, because NPs have training in all of these roles. Four of these thirty studies reported that informational support was the only support intervention, while the remaining 26 studies reported that informational support was given in combination with other forms of support. Method: January [cited 2016 Apr 15];8(1):1–7. https://doi.org/10.1371/journal.pone.0198424.s001, https://doi.org/10.1371/journal.pone.0198424.s002. This suggests that CHWs are used to target and focus on chronic glycemic control rather than acute control in T2DM management. Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. None of the selected studies covered all the purposes mentioned above. 2015 Nov;30(9):1207-27. doi: 10.1093/heapol/czu126. Education and support alone is not sufficient to provide self-management capabilities to T2DM patients. 2015 Mar 12;106(3):e157-64. Data curation, Chronic Disease Initiative for Africa, Division of Diabetic Medicine and Endocrinology, Department of Medicine, University of Cape Town, Cape Town, South Africa, Roles 2020 Jun 25;15(6):e0235037. The review will focus on the roles they (CHW) play, including what they do, how they are prepared to perform these roles and what they influence (outcomes). The SMART2D consortium includes the following partner institutions: Karolinska Institutet, Sweden; Institute of Tropical Medicine, Belgium; Collaborative Care Systems, Finland; Makerere University, School of Public Health, Uganda; University of the Western Cape, School of Public Health, South Africa; and Uppsala University, Sweden. Patients with poorly controlled blood sugar are more likely to benefit from CHW support compared to patients with better glycaemic control. This could result in researcher bias in including or excluding articles from full review. In the first model, CHWs are coordinated by intervention managers or research investigators, who are usually not employed by the health facility where the intervention is situated and where coordination is essential for intervention or research implementation. J Health Care Poor Underserved. From the review, training duration seemed to be associated with improved HbA1c and diabetes knowledge. In one of the studies, adult learning technique was applied in training CHW. It is important to mention that in HIC, HbA1c tests may be freely available as a routine diabetes investigation, but for many LMIC, routine access to HbA1c is limited. Once retrieved from the literature search (as ‘hits’), we selected articles through a two-stage process. CHWs often undertake different roles in T2DM self-management, with studies showing this to be an increasing trend between 2000 and 2015. ¶‡ These authors also contributed equally to this work. CHWs most frequently provide informational support giving advice and information about community and other vital resources to patients (n = 30). CHWs often receive on-the-job training and may work as … Validation, Non-inclusion of self-efficacy as part of a CHW led diabetes education intervention outcome could make it difficult to evaluate the actual impact of such intervention or the pathways through which any noted changes occurred. Firstly, all titles and abstracts were screened and eligible articles identified for full text retrieval. An article was included if the primary intervention focused on T2DM self-management or involved the use of CHWs or similar community-based non-professional health personnel. This support was frequently provided in addition to health education but sometimes it served the sole purpose of their service. Ongoing training of community health workers in low-income andmiddle-income countries: a systematic scoping review of the literature. Supervision, Nurses have a key role to play in the prevention, treatment and management of diabetes. School of Public Health, University of the Western Cape, Cape Town, South Africa, Contributed equally to this work with: Evidence and lessons from these interventions can be useful for Low- and Middle-Income countries (LMICs) such as South Africa that are experiencing a marked increase in T2DM prevalence. One study looked at the effectiveness of the different models of coordination mentioned above and showed that the NCM model of coordination was more effective than interventions where CHWs were not coordinated by nurses or where nurses alone provided T2DM services[68]. Screening for complications and referral of patients to relevant agencies when necessary are important aspects of their work, as is offering Diagram showing outcomes frequently targeted and reported in CHW supported self-management of type…, NLM It also examines the nurse’s role in assessing the health of the person with diabetes and in the delivery of care and its evaluation. Minorities and disadvantaged groups were the most frequently targeted groups for CHW assisted T2DM self-management interventions. CHWs also provide critical emotional support to T2DM patients. The definition of this support varied across studies, although it is commonly recognized as being crucial to successful self-management. Project administration, Archives of Internal Medicine 2009;169(19):1788-94. Yes HbA1c is the recommended standard test for glycemic monitoring in diabetes as it measures average plasma glucose over 2–3 months[81,82] and is thus the appropriate test if glycaemic control is the preferred outcome measure. Advocacy is the third commonly reported role played by CHWs for T2DM self-management (10 articles)[15,22,43,61–67]. Support services were often provided in combination and frequently tailored to each individual’s requirement. Understanding the impact of five major determinants of health (genetics, biology, behavior, psychology, society/environment) on type 2 diabetes in U.S. Hispanic/Latino families: Mil Familias - a cohort study. The treatment for type 1 diabetes is insulin. Available from. We initially defined and subsequently refined the research question based on the framework’s and other recommendations that broad scope research questions should be used to increase the amount of literature to be reviewed[7,8]. Disclaimer: This essay has been written and submitted by students and is not an example of our work. In the US, the National Community Health Advisor Study through a national survey listed seven basic roles for CHWs including cultural mediation, informal counselling & social support, education, advocacy, ensuring people get services they need, capacity building and direct service provision[74]. Like our physician colleagues, we have learned to diagnose, develop a plan of care and prescribe treatments. Citation: Egbujie BA, Delobelle PA, Levitt N, Puoane T, Sanders D, van Wyk B (2018) Role of community health workers in type 2 diabetes mellitus self-management: A scoping review. Most diabetes management relies on a person 'self … Diabetes Mellitus & Nurse’s Role PRESENTED BY: PROF.VIJAYREDDY VANDALI INDIA, Email id: vijayvandali@yahoo.com 2. 2018 Apr 28;8(4):e021467. Formal analysis, Writing – review & editing. Training models that deliver comprehensive knowledge and enhance CHWs’ capacity to deliver T2DM self-management support is lacking and needs to be developed. Instrumental support mostly involved helping patients to ‘navigate’ the health system and other systems that support the maintenance of healthy living such as social services[19,29], referrals and financial assistance. Peer reviewed scientific and grey literature was searched using a string of keywords, selecting English full-text articles published between 2000 and 2015. Which intervention design factors influence performance of community health workers in low- and middle-income countries? https://doi.org/10.1371/journal.pone.0198424.g005. Community Health Workers in Diabetes Management and Prevention AADE Practice Synopsis Issued June 4, 2015 Introduction Diabetes Self-Management Education (DSME) has long been acknowledged as an essential component of care for people with diabetes, as well as for persons at risk for the development of diabetes. … The aim of education varied between studies but increasing patients’ knowledge was most frequently reported. The key constructs were searched using combinations which also included synonyms according to the database being searched to ensure that articles with related terms were equally identified. This is given by subcutaneous injection by several means, including a syringe, pre-filled pens or a pen containing a pre-filled cartridge. Apart from the biophysical outcomes mentioned above, seventeen articles (31%) reported that T2DM knowledge was the key outcome measure. Initiating community-based interventions for primary prevention. It could however be argued that the use of CHWs for T2DM self-management is most common in the US and hence most research publications will be from this country. The role of the nurse in delivering community health care is considered an essential part in managing patient’s condition at home sitting. Epub 2017 Nov 22. There is no direct interaction between CHWs and usual patient care providers in this model (n = 17). Type 2 diabetes mellitus (T2DM) has become one of the major causes of burden of disease globally. The funders played no role in the preparation of this manuscript. Current statistics from the Centers for Disease Control and Prevention1 … Diabetic health educator can act as a catalyst for prospective changes and also can effectively position themselves to work effectively with experts, hospital managers and patients. The review was guided by a stepwise approach outlined in the framework for scoping reviews developed by Arksey and O’Malley. A good knowledge of the interaction between hemoglobin levels and HbA1c is also important since different hemoglobin levels could affect the interpretation of any HbA1c result obtained[83,84]. Education was the most frequently reported (n = 44) service provided by CHWs in T2DM self-management. Models of CHW care included facility linked nurse-led CHW coordination, facility-linked CHW led coordination and standalone CHW interventions without facility interaction. These individuals are often known to be longstanding members of the intervention communities and being ‘bilingual’ was frequently used as a criteria for recruitment. Peer reviewed scientific and grey literature was searched using a string of keywords, selecting English full-text articles published between 2000 and 2015. Often designated as the senior CHW, this person communicates with health facilities to facilitate the work of CHWs. The ultimate goal of T2DM education is to improve self-efficacy in individuals, and as such, any education falling short of this cannot be said to be adequate. The review was guided by a stepwise approach outlined in the framework for scoping reviews developed by Arksey and O'Malley. Thirdly, Improvement in blood sugar control does not always align with increased diabetes knowledge or self-management practice among T2DM patient as shown in our reviewed studies, which suggests existence of other mediators or pathways through which self-management support leads to improved clinical outcome. 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Fig 3 shows the distribution of different study designs. Aligned to this is a growing use of community health workers (CHWs) to deliver T2DM self-management support with good clinical outcomes especially in High Income Countries (HIC). It is possible that some articles have been missed, especially in the grey literature. Available from: International Diabetes Federation. Preparing CHWs to play their role in T2DM self-management is a critical yet often neglected component of intervention design. Venn diagram showing distribution of CHWs role in T2DM in selected articles, n…, Fig 5. DIABETES MELLITUS INTRODUCTION: Diabetes mellitus refers to a group of diseases that affect the body uses blood sugar (glucose). Improving diabetes prevention and management amidst varied resources: from local implementation to global learnings. Conceptualization, The review also showed that education only intervention using CHW is less likely to result in weight or BMI reduction compared to combination of education and support activities by CHW. Fig 1 shows the full process of article identification and selection for this studystudies. … HHS 2020 Sep 11;10(3):121. doi: 10.3390/jpm10030121. Data curation, As educators, CHWs are used to bridge this care gap by providing accessible education to people in their preferred locations, in particular focusing on disadvantaged populations. The longer the training duration, the more likely study is to report improved HbA1c and diabetes knowledge as the study outcome. Funding acquisition, No, Is the Subject Area "Health care facilities" applicable to this article? Just as CHW training duration and content are critical, the type and quality of training providers is also critical to successful knowledge transfer. The measures in our review were mostly related to T2DM knowledge and not inclusive of self-management or self-efficacy. You have already learned about what I must do to take care of my health. NIH Six studies (11%) reported that the training offered to CHWs lasted one week or less, and one article reported that the training duration was limited to four hours. CHWs deliver curriculum based education using manuals adapted from an existing document or documents developed purposely for the intervention. Roles Informational support refers only to non-curriculum based information on community resources for T2DM disease management. Objectives: To identify the views of nurses on their current and future roles in care in the community for people with Type 2 diabetes. Hispanics ar… No criteria were provided about how the duration of CHW training was decided upon in most of the articles. With this epidemiological shift predicted for the region, contextually appropriate but low resource approaches are needed to manage the disease. CHWs were mostly deployed to provide education, support, and advocacy. For PubMed search, the constructs were searched as MeSH terms, while for other databases, words such as ‘self-efficacy’ and ‘self-care’ were included as alternative to self-management, and ‘promotoras’, ‘promotores de salud’, and ‘community aides’ as alternative to CHWs. Yes Hispanics, most of whom were Mexican Americans, made up more than 50% of this group, with African Americans also frequently studied. Advocacy has not been comprehensively explored by diabetes program designers and CHWs have been reported to be on the periphery of formal health systems[79], without much integration, which may have hampered their role as advocates. Methodology, However, advocacy in this category refers to the role played by CHWs in helping participants communicate with their physician and health facility, ensuring that they receive good clinical services in line with stipulated guidelines. T2DM disease knowledge was also a frequently reported primary or secondary outcome in our review. The summary of included articles can be seen in S1 Appendix. We examine whether hospital and community DNS currently support the integration of care, examine regional variation in aspects of the service relevant to the delivery of integrated care and identify barriers to service delivery and areas for improvement. This study is part of the SMART2D project funded by the European Commission's Horizon2020 Health Coordination Activities (Grant Agreement No 643692) under call “HCO-05-2014: Global Alliance for Chronic Diseases: prevention and treatment of type 2 diabetes”. Training in study policies and procedures, technical skills, and diabetes education alone may not provide CHWs enough capacity to perform the role of health educators, and more may be required[80]. From the reviewed studies, only 13 (24%) reported that CHWs were provided training updates in order to support their initial training. Our categorization of CHW roles represents a functional approach to relaying their use in self-management interventions and is not different from the classifications described above. Most studies in this review lasted between 6–12 months and did not identify the need for ongoing training. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Having said these, it is important to recognize that not all patients will experience huge benefit in terms of reduction in HbA1c value when supported by CHW no matter the roles or combination of roles. USA.gov. Writing – original draft, Glucose is vital to health because it's an important source of energy for the cells that make up muscles and tissues. Fifteen articles reported blood pressure checks in addition to blood sugar level as a measure of effectiveness of intervention, while 16 articles reported that BMI was measured to monitor CHW effectiveness in T2DM self-management. doi: 10.1136/bmjopen-2017-021467. The roles and responsibilities of the nursing team relating to diabetes care include: Prevention advice, using behaviour change and health coaching techniques (See: Making Every Contact Count & Support Behaviour Change) Screening, prevention and early detection of type 2 diabetes; Promoting self-care; An awareness of how mental health issues … Findley et al (2012) in a New York State survey among CHWs and employers identified five basic roles played by CHWs including advocacy, education, community outreach, referral and cultural bridging[75]. here. Despite the above reported limitations, we are confident that the findings from this study are a true reflection of the roles CHWs play in T2DM self-management intervention. When a single role is used, we found that Education only approach leads to the best outcomes. There is therefore the need for triaging and selection criteria for the clients who will most likely benefit from CHW support as far as HbA1c reduction is concerned. [16–18]. Management of the disease is especially important because diabetes can lead to numerous complications, including kidney, eye and nerve issues. https://doi.org/10.1371/journal.pone.0198424.g001. We searched for articles in three peer reviewed journal databases and an online data source and used two databases to search for the full text of selected abstracts. COVID-19 is an emerging, rapidly evolving situation. JBI Database System Rev Implement Rep. 2015 Oct;13(10):30-40. doi: 10.11124/jbisrir-2015-1927. Project administration, Background: Utilization of diabetes management health care services and its association with glycemic control among patients participating in a peer educator-based program in Cambodia. This suggests that there could be usefulness to triaging of patients most at risk for the sake of providing CHW support. 2015. Writing – original draft, Charting was done by the first author with regular iteration among all co-authors, based on a review of the available information in each article, which was updated as new information emerged. Other instrumental roles reported in the selected studies included helping with paperwork for services, accompanying patients, and arranging health services. Chronic Disease Initiative for Africa, Division of Diabetic Medicine and Endocrinology, Department of Medicine, University of Cape Town, Cape Town, South Africa, Roles Norris et al (2006) found a great variability in the roles played by CHWs in diabetes care[76]. Roles Method. Global Report on Diabetes [Internet]. Thirty-eight (70%) of the studies reported that glycosylated hemoglobin (HbA1c) was the biomarker used to monitor blood sugar control and measure the success of intervention. Objectives: Brussels, Belgium; 2015. e0198424. As nurses working in community care, a number of responsibilities are involved in care of patient with diabetes including assessment and providing optimal intervention (Carey & Courtenay, 2008). Writing – review & editing. Writing – review & editing, Affiliations Education was often provided using paper tools but occasionally with electronic tools[17,33]. Community health nurse has a number of responsibilities regarding diabetic patients care include effective assessment and providing teaching plan that help the patient to maintain controlled blood sugar level. The focus of PI led CHW training was often related to the study protocol. While high school diploma was frequently required for selection (16 articles), one article reported that there was no academic qualification requirement for selection as a CHW. Preparing and coordinating CHWs for these roles is crucial and needs further research and strengthening. Practice nurses in particular play a clinical role in screening, maintaining and supporting people with diabetes. http://apps.who.int/iris/bitstream/10665/204871/1/9789241565257_eng.pdf, http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=4390559&tool…. We found a five-fold increase in the number of relevant articles between the five year period 2011–2015 and the six year period 2000–2005, as shown in Fig 2. https://doi.org/10.1371/journal.pone.0198424.g002. 2020 Jan 6;20(1):4. doi: 10.1186/s12902-019-0483-z. Key words: Role, Diabetes, Specialist, Nurse, DSN. CHWs play several useful roles in T2DM self-management that includes structured education, ongoing support and health system advocacy. We found different coordination models which either made CHWs outsiders or insiders to patient routine care. Venn diagram showing distribution of…, Fig 4. This role overlaps somewhat with the ‘instrumental support’ function as some articles reported referral support and setting up doctor’s appointments as advocacy. Investigation, Software, Case Study of Diabetes Mellitus and Community Health Nurse. 2020 Feb 28;9:42. doi: 10.4103/jehp.jehp_555_19. Our classification is however based on CHWs’ role in diabetes self-management only, while some of the roles mentioned in studies above are for several other chronic conditions. The only study that reported no improvement in diabetes knowledge had CHWs trained for a total duration of less than five hours. The effects of a nurse case manager and a community health worker team on diabetic control, emergency department visits, and hospitalizations among urban African Americans with type 2 diabetes mellitus: a randomized controlled trial. Structured curriculum based education was the most frequently reported service provided by CHWs to support T2DM self-management. Diagram showing number of articles on CHW led T2DM self-management intervention in each…, Fig 3. These retrieved full texts articles were subsequently screened for eligibility and selected according to set inclusion criteria. Funding acquisition, Models that integrate CHW coordination within the health system and give CHWs access to regular patient care were found to be effective. doi: Levitt NS, Puoane T, Denman CA, Abrahams-Gessel S, Surka S, Mendoza C, et al. Keegan CN, Johnston CA, Cardenas VJ Jr, Vaughan EM. Alaofè H, Asaolu I, Ehiri J, Moretz H, Asuzu C, Balogun M, Abosede O, Ehiri J. Ann Glob Health. Aligned to this is a growing use of community health workers (CHWs) to deliver T2DM self-management support with good clinical outcomes especially in High Income Countries (HIC). Conceptualization, There is evidence of improved clinical outcomes for T2DM self-management interventions when a CHW works with, and is coordinated, by a health facility linked nurse for program delivery[31,61,68]. Evaluating the Impact of Telehealth-Based, Diabetes Medication Training for Community Health Workers on Glycemic Control. Using random role of community health nurse in diabetes mellitus sugar to measure blood sugar control among T2DM patients n... Work witten by our professional work witten by our professional essay writers in developing countries the region, contextually but. Other forms of support risk of developing a foot ulcer role of community health nurse in diabetes mellitus seen in S1 Appendix multidisciplinary training physicians. Countries [ 82 ] role of community health nurse in diabetes mellitus and self-management of T2DM when CHWs are commonly used as educators... 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