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. 2014 Sep 4;2014(9):CD006424. doi: 10.1002/14651858.CD006424.pub3

Babamoto 2009.

Methods Parallel randomised controlled clinical trial (RCT)
Randomisation ratio: 3 groups 1:1:1
Superiority design
Participants Inclusion criteria:
  • Hispanic/Latino by self‐report

  • 18 years of age or older

  • Diagnosis of type 2 diabetes (via ADA criteria) within 6 months of study enrolment


Exclusion criteria:
  • Participants with gestational diabetes

  • Participants who had previous diabetes case management


Diagnostic criteria:
Interventions Number of study centres: 3
Treatment before study: no
Intervention group: a CHW‐led intervention consisting of individual education sessions at participant's home/clinic/community location and supporting telephone calls; education sessions lasted for a 10‐week period (unclear how frequent they were). CHWs were bilingual Hispanics; education sessions were tailored to participant needs—some topics may have been covered more then once, some not at all, depending on participant needs; telephone calls were made 'routinely' during this period and then for 14 weeks after the intervention (up to 6 months). The second intervention group received case management by culturally sensitive nurses
Control group: received no extra contact
Outcomes Outcomes reported in abstract of publication:
  • HbA1c

  • BMI

  • Diabetes knowledge

  • Emergency department admissions

  • Physical activity

  • Medication‐taking behaviour

  • Dietary intake (incl. fruit and vegetable intake and fatty food intake)

  • Health status


Primary outcome(s):
Secondary outcome(s):
Outcome measures were assessed at completion of the 6‐month intervention programme
Study details Run‐in period: unclear
Study terminated before regular end: no
Publication details Language of publication: English
Funding: not stated
Publication status: peer‐reviewed journal
Stated aim of study Quote from publication: "Evaluate the relative effectiveness of a CHW intervention among Hispanic persons with newly diagnosed type 2 diabetes (compared with case management and usual care)"
Notes
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk Comment: randomisation via a "random‐number table"
Allocation concealment (selection bias) Unclear risk Comment: not commented upon
Blinding of participants and personnel (performance bias) 
 Objective outcomes High risk Comment: no one was blinded—participants, providers or outcome assessors
Blinding of participants and personnel (performance bias) 
 Subjective outcomes High risk Comment: no one was blinded—participants, providers or outcome assessors
Blinding of outcome assessment (detection bias) 
 Lab tests: Lipids, HBA1C Unclear risk Comment: no one was blinded—participants, providers or outcome assessors; unlikely to affect objective measurement of HbA1c, but BMI can be more subject to bias in measurement (e.g. rounding differences)
Blinding of outcome assessment (detection bias) 
 Subjective outcomes High risk Comment: no blinding
Incomplete outcome data (attrition bias) 
 Objective outcomes High risk Comment: not an ITT analysis. High attrition rate and differences between groups (43%‐50% control and 28% intervention)
Incomplete outcome data (attrition bias) 
 Subjective outcomes High risk Comment: as above
Selective reporting (reporting bias) Unclear risk Comment: protocol not seen
Other bias Unclear risk Comment: none