Abstract

The Jamaican Lay Facilitators Program: a positive impact on glycemic control

Author(s): Lurline A Less, Dalip Ragoobirsingh, Errol Y Morrison, Michael S Boyne & Pauline Anderson Johnson

Aims: To improve glycemic control and lower BMI among patients with Type 2 diabetes using lay diabetes facilitators (LDFs).

Methodology: An intervention study was conducted in 16 health centers (in two rural areas and one urban area) in Jamaica to evaluate the effect of LDFs on glycemia (hemoglobin A1c [HbA1c]) and BMI. In the intervention arm, LDFs were recruited and trained from eight clinical settings and 159 participants were recruited. Another 159 participants from eight comparable clinical settings without LDFs comprised the matched control group. The study was 12 months in duration with HbA1c and BMI measured at 6-monthly intervals.

Results: Mean HbA1c at baseline for the intervention and comparison groups were 7.94 ± 2.12 and 8.08 ± 1.98%, respectively. After 6 months, the intervention group showed a mean decrease of 8.1% while the comparison group showed an increase of 8.2%. At 12 months, there was further improvement in the HbA1c in the intervention group to 7.08 ± 1.03%, representing an overall reduction of 12.6%, while the comparison group showed even further deterioration in the HbAIc to 8.89 ± 1.69%. There was no statistically significant change in BMI between groups.

Conclusion: Using the trained LDFs to provide education made a positive difference and showed that effective education can be provided by LDFs. LDFs can also positively assist in sustained quality of care in individuals with diabetes and should be included in the healthcare delivery team.