Abstract 4 - Role of lay health workers in diabetes management: Design of a pragmatic randomized controlled trial for people living in inadequate housing (JC School of Public Health and Primary Care)
Title: Role of lay health workers in diabetes management: Design of a pragmatic randomized controlled trial for people living in inadequate housing
Background: People living with low socio-economic status, for example those living in inadequate houses, are at higher risk to develop diabetes due to their inaccessibility to medical services, particularly with the service suspension in public in COVID-19 pandemic. To extend the capacity of health system, lay health workers can help manage chronic diseases under supervision, and is the key to provide accessible care in community settings despite their lack of formal medical trainings.
Objectives: This is a pragmatic randomized controlled trial to investigate the effect of a 6-months lay health worker intervention in diabetes management among Chinese living in sub-divided flats units in Hong Kong, a high-income developed economy.
Methodology: In this trial, 222 Chinese primary caregivers living in inadequate houses will be recruited via non-profit organizations serving in districts with low average household incomes and prevalent sub-divided flats in Hong Kong. Adopting a 3 to 6 months wait-list control, participants will be randomized to receive a 6-months lay health worker intervention of 5 components, including 1) lay health worker training and support; 2) health professional training; 3) formulation of targeted care plan for the health and nutritional needs of the families; 4) case management approach; and 5) financial subsidy for lay health workers to sustain practice. Control group will receive usual care of and a health information leaflet on diabetes risk management. Glycated hemoglobin (HbA1c) and fasting blood glucose will be taken at the entry and exit assessment of this trials as primary outcomes.
Results and Conclusion: This trial could be one of the first studies to investigate the effect of lay health workers intervention on diabetes management in Chinese population living in poverty. Results could shed light on alternative options in providing chronic disease support for people living in health-compromising environments at an accessible cost, and therefore provide insights on improving the health and wellbeing of the residents in other developed cities.