Community health workers improve diabetes care in remote Australian Indigenous communities: results of a pragmatic cluster randomized controlled trial

Indigenous Australians have the highest prevalence and incidence of diabetes in Australia and also suffer high rates of preventable complications. Many of these complications can be prevented with better primary care level management however access to culturally appropriate high quality diabetes care is not always evident, especially in remote settings where there is high turnover of health staff.

Previous reports suggest that community health workers can contribute to improved diabetes care and outcomes in high risk and under-served patients in Australia and elsewhere through more effective communication and culturally appropriate self-management support, although until recently, few studies use robust randomized controlled designs.

The authors aimed to evaluate the effectiveness of a community-based health-worker led case management approach to the care of Indigenous adults with poorly controlled type 2 diabetes in primary care services in remote northern Australia.