Characteristics of diabetes prevention programmes using nonprofessional health workers: a systematic review
Jillian Hill1,&, Andre Pascal Kengne1
1Non Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
Jillian Hill, Non Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
a number of large randomised controlled trials have proven that lifestyle interventions can be successful in reducing the incidence of T2D, between 29-58% in high-risk populations. The intensity and resources requirements for those interventions in successful efficacy trials of diabetes prevention are however deterrent to their uptake in routine primary care or community-based settings. The shortage and labour cost impede the employment of health care and allied professionals as intervention implementers in wide-scale diabetes prevention programmes (DPPs). Empowering community or lay health workers has already been identified as a key mechanism in various health promotion efforts and interventions. Non-professional health workers (NPHW) have already been used to deliver components of diabetes management, both in health care and community-based settings, with indications of favourable effects on the outcomes of care. Generally, DPPs utilising nonprofessional implementers have not been systematically characterised, while such information is needed to assist their replications worldwide. This systematic review aims to characterise completed or ongoing nonprofessional implementers centred DPPs around the world.
the electronic databases MEDLINE via PubMed Central, EBSCOHost, SCOPUS/EMBASE were searched. A total of 18906 entries were identified via database searches. After removal of duplicates and screening of titles and abstracts, 182 were selected for further evaluation via full text, of which 41 met the inclusion criteria and therefore form the basis of this review.
the synopsis provide evidence to support an increasing use and empowerment of NPHWs in the implementation of DPPs.
however, it appears to be the case more in affluent countries, in particular the USA, and less in resources-limited areas; where NPHWs may have a more critical role; which point to the need for studies in other countries, especially in Africa, more specifically South Africa with its high burden of diabetes and a growing at risk population.