The article under review is titled: “Results of the Manhattan diabetes community outreach project: A randomized trial studying a community health worker interventions to improve diabetes care in Hispanic adults.” The article was published in Diabetes care Journal volume 37 of April 2014. It is a peer-reviewed article.

The article has an abstract that contains the objectives of the study, research design and methods, and the conclusions that the authors made after analyzing the results. The research is based on a significant aspect of care delivery as determined by the authors through a review of the literature. The authors sought to find out the worker-intervention in the improvement of diabetes care among the Hispanics. AccordingThe literature review showed that the Hispanics are more severely affected by the current diabetes pandemic than the Whites. The literature review also revealed a total of seven randomized trials that focused on the efficacy of community health care workers in the improvement of glycemic control, as determined by the decrease in the serum hemoglobin A1c. The authors report that, out of the seven studies, only three of them performed randomized studies for over a year. As such, and considering the value of community health workers in addressing chronic diseases like diabetes, the authors saw the need to carry out the study. Additionally, the authors had established that there was a great need to design and validate a culturally-friendly model of care for the Hispanics suffering from diabetes (Palmas et al., 2014).

The research was done over a one-year period through a participatory research project. The two institutional partners in the study included the AlianzaDominicana Inc. and the Columbia University Medical Centre. The researchers recruited 360 Hispanic participants of ages between 35-70, suffering from type 2, poorly uncontrolled diabetes, and enrolled in a primary care setting. The authors also clearly defined their inclusion and exclusion criteria. Among the consideration of the inclusion criteria included Hispanic diabetic patients with last A1c of less than, or equal to 8% measured in the preceding 12 months. (Palmas et al., 2014). They did the randomization within the PCP practice to prevent confounding by the PCP Interventional practice patterns. They prevented imbalances by including a term identifying the PCP in the analytic model. They collected data by measuring A1c using latex agglutination assay. The researchers collected the questionnaires using computer-assisted personal interviewing system.

A1c. Secondary outcomes included systolic blood pressure, diastolic blood pressure and LDL-cholesterol. The researchers was a modest improvement in the A1c levels among the participants in the intervention group as compared to the control group, the smaller values lacked statistical significance. The secondary outcomes also showed nonsignificant improvements. In essence, the overall results failed to satisfy statistical significance.

A critical look at this research article shows a research that succeeded in the application of the research process in some aspects, but failed in other aspects. As regards the topic of study, the purpose of the study was very clear. The authors gave a concise background to the problem under study, and they were able to convince the reader that the study was necessary. The problem was identified as a limitation in the access to good care among the Hispanic minorities in the United States, at a time when community health workers have been found to be very beneficial in the delivery of care for chronic patients in primary care settings (Palmas et al., 2014, P. 964). They clearly stated the study purpose as investigating the efficacy of CHWs in providing care for type two diabetes, among Hispanic patients. As such, the study would contribute greatly in improving nursing care delivery, as well as, contributing to the body of knowledge of the nursing profession. In essence, positive results would be used to develop and validate a culturally-friendly model of care for the Hispanics (Palmas et al., 2014, P. 964).

As regards the research design and methodology, the authors have not stated a clear theoretical framework to guide their research. However, in the inclusion and the exclusion criteria. The characteristic aspects of the participants have been clearly stated as they have also been divided into the intervention and the control group. The research question has not been clearly stated. It has been left to the readers to guess. However, the variables of the study and the aspects being investigated have been described comprehensively. Ethically, the research protocol was reviewed by the CUMC Institutional Review Board.

In the background, the authors have also drawn heavily from previous studies on the subject. The literature review, however, does not seem comprehensive. The background of the study has cited very few studies, which have been repeated on the results part. Although their research has referenced some articles as old as 1972, about eighty percent of the references used are not older than ten years from the time of the study. Such consideration is important in improving the credibility of the results.

The data collection techniques employed by the researchers are credible. They randomized the participants in a systematic manner and collected data by measuring A1cPalmas et al., 2014, P. 968). Since the characteristics of the study populations are different from the general population, generalizations may not be made.

The research is very significant to nursing practice, research and education. The authors have identified the need for further research and made recommendations on the same (Palmas et al., 2014, P. 968). Their results need to be verified through further research. Since their results are statistically non-significant, a meta-analysis of the available data is needed in order to clearly inform nursing practice regarding the subject. Nursing research education regarding best practices like following participants closely using phone calls needs to be emphasized.

Reference

Palmas, W., Findley, E.S., Mejia, M., Batista, M., Teresi, J., Kong, J… &Carrasquillo, O. (2014).Results of the Manhattan diabetes community outreach project: A randomized trial studying a community health worker interventions to improve diabetes care in Hispanic adults.Diabetes Care, 37, 963-969.