The impact of integrating medical assistants and community health workers on diabetes care management in community health centers

Table 1 A comparison of medical assistant and community health worker roles in managing diabetes care for training and implementation

	Medical assistant intervention arm	Community health worker intervention arm	Control group arm^a
Pre-visit
Discuss the patient case with the physician	X
Agenda setting with the patient	X	X
Ordering routine services	X	X	X
History tracking	X
During the Visit
Document physician findings	X
Send electronic prescriptions to pharmacy	X
Write prescriptions for the physician to sign	X
Post-visit
Discuss patients’ concerns	X	X
Recapitulate the advice given by the physician	X	X
Set goals with the patient	X	X
Make sure that patients can navigate the system		X
Between Visits
Provide culturally appropriate and accessible health education and information	X	X
Assure that people with diabetes receive the services they need	X	X	X
Follow up over the phone	X	X
Offer informal counseling and social support		X
Provide information to families to support the lifestyle changes of patients with diabetes		X
Build individual and community capacity		X

^aCommunity health center sites in the control group did not implement major changes to diabetes care processes during the study period, as verified by key informant interviews during the study period. Most control CHC sites, however, had some support for pre-visit ordering of routine diabetes services and follow up to assure services were received for patients in general (not specific to patients with diabetes)

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