Accepted for/Published in: JMIR Research Protocols
Date Submitted: Feb 13, 2024
Date Accepted: Jun 5, 2024
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Does training of Community Health Workers in diabetes lead to improved outcomes for diabetes, screening and management in low-and-middle-income-countries: A systematic review protocol
ABSTRACT
Background:
Diabetes, particularly Type 2 Diabetes Mellitus (T2DM), is a global health crisis disproportionately affecting low- and middle-income countries (LMICs). Task-shifting strategies employing Community Health Workers (CHWs) have emerged as a promising approach to address healthcare barriers in LMICs, although their effectiveness in diabetes management remains uncertain.
Objective:
To establish the protocols for a systematic review assessing whether training CHWs in diabetes management leads to improved outcomes in screening and managing diabetes in LMICs.
Methods:
The systematic review protocol follows the PRISMA guidelines and has been registered with PROSPERO (CRD42022341717). Eligible studies will include randomised controlled trials and meta-analyses conducted between January 2000 and December 2023, focusing on training CHWs in diabetes management in LMICs. Studies will be searched in various databases, including PubMed, Scopus, Cochrane Central, and others. The review will include studies reporting outcomes such as changes in diabetes referrals, screenings, HbA1c values, and fasting blood glucose levels. Data extraction will be independently conducted by two reviewers using a custom-made form, with discrepancies resolved by a third reviewer. Risk of bias assessment will follow Cochrane and ROBINS tools for randomized and non-randomized studies, respectively. A narrative synthesis will explore the intervention's effects and implementation factors, with subgroup analyses planned based on CHW types and demographic factors. Meta-analysis will be conducted for the outcome measures.
Results:
The systematic review aims to provide comprehensive evidence on the effectiveness of training CHWs in diabetes management in LMICs. Findings will be synthesized narratively and, if feasible, through meta-analysis.
Conclusions:
This systematic review protocol outlines a rigorous methodology to evaluate the impact of training CHWs in diabetes management in LMICs. By synthesizing available evidence, this review aims to present scientific evidence of the highest order for CHW training design and associated policies. Clinical Trial: The trial has been registered with PROSPERO (CRD42022341717)
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