Participating institutions name and acronyms

·         Wuqu Kawoq/ Maya Health Alliance

·         INCAP

·         Instituto de Salud Integral, ISIS

CIIPEC Researchers

Carlos Mendoza Montano

Abstract

Guatemala is witnessing a rapid increase in the prevalence of type 2 diabetes. In higher income settings, intensive, individualized interventions for self-management of type 2 diabetes have proven to be cost-effective and efficient mechanism to improve control of type 2 diabetes. Type 2. This is especially the case for people with the highest risk of death and disability, such as those with very high levels of glycated hemoglobin (A1C). In this project, we will support providers' efforts at two sites in rural Guatemala to improve management of patients with type 2 diabetes. We will do this by implementing a self-management intervention for intensive type 2 diabetes in the home delivered by auxiliary nurses from the community and community health workers to people with diabetes. This intervention may be especially beneficial for people with severe diabetes who tend to face very significant barriers to receiving behavior change interventions, including secondary illnesses, economic factors, and family preferences.

General objective

The objective of this project is to carry out an analysis of the clinical effectiveness and the implementation of a large-scale self-management intervention for people with type 2 diabetes in two different settings in rural areas of Guatemala.

Methodology

The project will implement a 6-month self-management intervention in Tecpán, Chimaltenango and Guineales, Sololá, with approximately 1,000 individuals with type 2 diabetes.

The project will evaluate the effectiveness of the program with respect to:

Glycated hemoglobin

Blood pressure

Weight and waist circumference

Diabetes related knowledge and behavior

In addition to the clinical and knowledge indicators at the patient level, the project will also monitor the implementation of the intervention using the RE-AIM framework (representation, effectiveness, adoption, implementation, and maintenance) in both settings.

Project duration

Sept 2018-Dec 2020