November - 6 - 2009
A culturally tailored diabetes intervention may help reduce emergency room (ER) visits for urban African Americans, new research suggests. The study authors randomly assigned 542 African Americans with type 2 diabetes to receive either intensive or minimal intervention in an urban managed care organization. The minimal intervention group received mailings and telephone calls every six months to remind the participants about preventive screenings. Patients in the intensive intervention group received the calls and mailings as well as individualized, culturally tailored care with a nurse case manager (NCM) and a community health worker (CHW). Blind observers collected data on diabetes control at the study baseline and at 24 months, while administrative data was used to assess ER visits and hospitalizations. The patients had a mean age of 58 years, with 50 percent living in poverty. After 24 months, patients in the intensive group were 23 percent less likely to have ER visits compared to the minimal intervention group, with the rate reduction strongest for patients who received the most NCM and CHW visits.