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Open Access Study protocol

Protocol for the DREAM Project (Diabetes Research, Education, and Action for Minorities): a randomized trial of a community health worker intervention to improve diabetic management and control among Bangladeshi adults in NYC

Nadia Islam1, Lindsey Riley1*, Laura Wyatt1, S Darius Tandon2, Michael Tanner1, Runi Mukherji-Ratnam3, Mariano Rey1 and Chau Trinh-Shevrin1

Author Affiliations

1 Department of Population Health, New York University School of Medicine, 227 East 30th Street, 8 F, New York, NY 10016, USA

2 Department of Medical Social Sciences, Northwestern University, 750 N Lake Shore, Chicago, IL 60611, USA

3 Psychology Department, State University of New York, 210 Store Hill Road, Old Westbury, NY 11568, USA

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BMC Public Health 2014, 14:177  doi:10.1186/1471-2458-14-177

Published: 18 February 2014

Abstract

Background

New York City (NYC) is currently home to the largest Bangladeshi population in the United States (US) at approximately 62,000 individuals. The high prevalence of Type 2 diabetes mellitus (T2DM) among Bangladeshis has been well documented in Bangladesh, as well as in Canada and the United Kingdom (UK). However, little is known about the diabetes prevalence and management practices of US Bangladeshis. This paper describes the protocol for a Community Health Worker (CHW) intervention to improve diabetic management and control among Bangladeshis with diabetes in NYC.

Methods/Design

For a two-arm, randomized controlled trial (RCT), investigators will recruit a sample of 256 participants, all of whom are 1) of Bangladeshi descent, 2) residing in NYC, 3) diagnosed with T2DM and a recent Hemoglobin A1c (HbA1c) of ≥ 6.5, and 4) between the ages of 21–85. The treatment group receives a six-month CHW-led intervention consisting of five monthly group educational sessions, two one-on-one visits, and follow-up phone calls as needed from a CHW. The control group receives an introductory educational session only. Primary and secondary outcomes include clinical and behavioral measures, such as HbA1c and weight change, access to and utilization of care (i.e. appointment keeping and use of specialty care), and knowledge and practice of physical activity and healthful eating. Additionally, information regarding CHW characteristics, the processes and mechanisms for influencing healthful behavior change, and fidelity of the intervention are collected. Outcomes are measured at Baseline, 3-Months, 6-Months for both groups, and at 12-Months for the treatment group.

Discussion

To our knowledge, this study represents the first attempt to document the efficacy of T2DM management strategies in the NYC Bangladeshi population. Thus, future qualitative and quantitative findings of the submitted protocol will fill an important gap in the health disparities literature.

Trial registration

NCT02041598

Keywords:
Health disparities; South Asian Health; Diabetes; CHW; CBPR