Structured Telehealth Community Health Worker–Clinician Feedback and Diabetes Outcomes: A Randomized Clinical Trial
Primary result · Change in HbA1cResult — go to the resultNet difference −1.0 percentage points 95% CI −1.5 to −0.4Authors' conclusion
In this randomized clinical trial, the CHW intervention significantly improved diabetes outcomes in low-income settings, potentially by reducing fragmentation through structured feedback.
Study context
- Population
- Low-income, uninsured White Hispanic adults with T2D at 3 community clinics in Texas; mean age 54 years, 64.6% femaleITT analysis
- Participants
- 257 participants
- Comparison
- CHW intervention vs usual care
- Interventionn = 129
- Controln = 128reference
- Primary endpoint
- Change in hemoglobin A1c (HbA1c)
- Follow-up
- Baseline to 12 months
Methodological detailsmulticentre, 12-month
- Multicentre
- 12-month
Primary result
As reported in the abstract
12 months
Net difference
−1.0 percentage points
95% CI −1.5 to −0.4
P = 0.001
Interventionvs Control
net difference −1.0 percentage points (95% CI −1.5 to −0.4); P = 0.001
Secondary outcomes
| Outcome | Net difference (mg/dL) (95% CI) | P value | |
|---|---|---|---|
| Total cholesterol change · baseline to 12 monthsIntention-to-treat analysis | −35.4 (−54.6 to −17.2) | P = 0.02 | |
| LDL-C change · baseline to 12 monthsIntention-to-treat analysis | −29.7 (−44.5 to −14.9) | P < 0.001 | |
| −100−50050Difference, mg/dL (linear scale) |
American Diabetes Association (ADA) guideline adherence: foot examinations
- Improved adherence, absolute risk (pp), 95% CI 7.4-30.9
- 19.2
- Improved adherence, RR, 95% CI 1.19-2.27
- 1.65
- P
- P = 0.03
ADA guideline adherence: urine microalbumin screening
- Improved adherence, absolute risk (pp), 95% CI 5.3-26.3
- 15.8
- Improved adherence, RR, 95% CI 1.07-1.43
- 1.24
- P
- P = 0.048
Feedback loop issue resolution
- Participant concerns addressed by community health workers (CHWs) via feedback loop (medication refills, glucose management, access to care)
- 490 (87.2%)
Original publication
Structured Telehealth Community Health Worker–Clinician Feedback and Diabetes Outcomes: A Randomized Clinical Trial. JAMA Intern Med. Published 1 August 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →