ArticlePreventing chronic disease2021
Implementation of a Diabetes Self-Management Education and Support Intervention in Rural Guatemala: A Mixed-Methods Evaluation Using the RE-AIM Framework.
Article in Preventing chronic disease, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Costs and cost-effectiveness of a culturally adapted diabetes self-management and education program for Marshallese adults.Journal of clinical and translational science · 2026Article
- Scaling up structured lifestyle interventions to improve the management of cardiometabolic diseases in low-income and middle-income countries: a systematic review of strategies, methods and outcomes.BMJ public health · 2025Article
- Impact of COVID-19 on diabetes care: mixed methods study in an Indigenous area of Guatemala.BMJ open · 2024Article
- Adults' Experiences with Type 2 Diabetes in Rural Guatemala: A Qualitative Study.Journal of health care for the poor and underserved · 2023Article
- Implementation of a Diabetes Self-Management Education and Support Intervention in Rural Guatemala: A Mixed-Methods Evaluation Using the RE-AIM Framework.Preventing chronic disease · 2021Article
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Authors and funding
11 authors.
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Abstract
introductionTo address the global diabetes epidemic, lifestyle counseling on diet, physical activity, and weight loss is essential. This study assessed the implementation of a diabetes self-management education and support (DSMES) intervention using a mixed-methods evaluation framework.
methodsWe implemented a culturally adapted, home-based DSMES intervention in rural Indigenous Maya towns in Guatemala from 2018 through 2020. We used a pretest-posttest design and a mixed-methods evaluation approach guided by the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework. Quantitative data included baseline characteristics, implementation metrics, effectiveness outcomes, and costs. Qualitative data consisted of semistructured interviews with 3 groups of stakeholders.
resultsOf 738 participants screened, 627 participants were enrolled, and 478 participants completed the study. Adjusted mean change in glycated hemoglobin A
conclusionA community health worker-led DSMES intervention was successfully implemented in the public health system in rural Guatemala and resulted in significant improvements in most clinical and psychometric outcomes. Scaling up sustainable DSMES in health systems in rural settings requires careful consideration of local barriers and facilitators.
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