As countries become more affluent and people adopt richer diets and more sedentary lifestyles, chronic diseases impose an increasingly heavy burden in death, disability, and medical costs. The search for cost-effective ways to treat diabetes and other chronic diseases like hypertension and coronary heart disease has become a major priority, especially for a country like the United States, where an estimated 21 million people have diabetes, or about seven percent of the total population. PACT hopes that their new initiative, which will provide services to about 50 patients in a pilot study, will eventually show that the accompagnateur model can be successfully used to improve treatment of diabetes.
The new project will target high-risk diabetes patients, many of whom suffer from other conditions that increase the risk of treatment failure, such as obesity, mental health issues, and poverty. Many of these patients have also failed to stay with treatments in other programs. The initiative is partnering with the Codman Square Health Center and the Dorchester House Multi-Service Center, which serve three of the four neighborhoods with the highest rates of diabetes-related deaths in the Boston area—Mattapan, Dorchester, and Roxbury.
Like PACT’s HIV/AIDS program, accompagnateurs in the new diabetes project will visit about 90 patients in their homes and deliver medical services, social support, and education on diabetes, nutrition, and exercise. The project will also work to improve access to affordable healthy foods and exercise opportunities in the community, and help the health center provide more activities for their diabetic patients (such as exercise groups and snack clubs). A control group will receive standard care at their health center.
“Ultimately we hope not only to positively impact those patients in the program and study, but also to contribute data to local and national movements to improve the working conditions of CHW’s and the sustainability of CHW based programming,” writes Leah Jacobs, the project’s coordinator.
[posted November 2008]