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CSAAH Publication Community Brief
Protocol for the DREAM Project (Diabetes Research, Education, and Action for Minorities):
randomized trial of a community health worker intervention to improve diabetic management and
control among Bangladeshi adults in NYC
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Nadia Islam , Lindsey Riley , Laura Wyatt , S Darius Tandon , Michael Tanner ,
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Runi Mukherji-Ratnam , Mariano Rey and Chau Trinh-Shevrin
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Center for the Study of Asian American Health, Department of Population Health, New York University School of Medicine,
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New York, NY, USA; Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA; Psychology
Department, State University of New York- Old Westbury, New York, NY
WHAT IS THE PURPOSE OF THIS STUDY?
• To describe the protocol of the DREAM (Diabetes Research, Education and Action for Minorities) Project
for a 6-month Community Health Worker (CHW) intervention to improve diabetic management and
control among Bangladeshis with Type II diabetes in NYC. CHWs are frontline public health workers who
have a unique understanding of and are trusted members of the community served, and have been
identified as effective liaisons in improving access to services by helping to bridge communities and
healthcare systems.1,2
WHAT IS THE PROBLEM?
• The World Health Organization (WHO) estimates Bangladesh as one of ten countries in the world with
the highest number of cases of Type 2 diabetes mellitus. Despite the statistic, not much is known about
the presence and management of diabetes among Bangladeshis residing in the US or in NYC.
• The Bangladeshi population is among the fastest growing Asian ethnic groups in NYC. Immigrants
accounted for 74 percent of Bangladeshis in NYC and just about half of the population has lived in the
U.S. less than 10 years.3 Additionally, 53% of Bangladeshis in NYC speak English less than “very well”
and about 33% live below the poverty line. This information highlights the need for services and
programming that address the specific language and cultural needs of this largely immigrant community.
• Though there is much need for interventions focusing on Bangladeshis, there are very few programs for
this community that offer services in-language, and materials that address cultural and social norms,
attitudes and behaviors. Programming led by CHWs who have an in-depth understanding of the
community norms, attitudes and values can fill the existing health-service gaps.
WHAT ARE THE FINDINGS?
• The project recruited participants through mailings, tabling at screening events, and follow-up phone
calls targeting the Bangladeshi community in NYC. Enrolled participants who were eligible for
participating in the study were then invited to an introductory educational session, at which time they
were randomly assigned to either the treatment group who received the intervention (n= 96
participants) or the control group (n= 96 participants).
• The treatment group received five additional education sessions led by the CHW (over a six-month
period), two one-on-one visits with the CHW, and surveys at three-month intervals. Control group
participants were surveyed at three-month intervals and given a chance to participate in the rest of the
program during a following round of the study.
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Support for Community Health Workers to Increase Health Access and to Reduce Health Inequities (http://bit.ly/1iAWnbj)
Chin MH, Walters AE, Cook SC, Huang ES. Interventions to reduce racial and ethnic disparities in health care. Medical care research and review: MCRR
2007;64:7S-28S.
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Asian American Federation Census Information Center- Profile of New York City’s Bangladeshi Americans: 2013 Edition (http://bit.ly/PUZEdq)
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CSAAH Publication Community Brief
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The project is currently ongoing and plans are in place to measure blood sugar, blood pressure, blood
cholesterol levels as well as physical activity, healthy eating practices and health care facility use at the
end of the study to see if there are differences between the treatment and control groups.
Project researchers and coalition members also intend to gather information on how CHWs can serve as
a resource to decrease the health access gap and improve health outcomes among immigrant
communities in the US and NYC.
These study plans that have been developed and implemented by the DREAM Project can be used to
inform CHW programs focusing on other communities and other health outcomes.
WHO SHOULD CARE MOST?
• Researchers and policy-makers interested in developing culture-specific programs for disease
prevention and management in minority communities
• Healthcare facilities, community organizations, researchers, health care providers and policy workers
working with Asian American communities in the United States and the New York metropolitan area
• Health advocates working in Asian American communities
CITATION
• Islam, N., L. Riley, L. Wyatt, S. D. Tandon, M. Tanner, R. Mukherji-Ratnam, M. Rey and C. Trinh-Shevrin
(2014). "Protocol for the DREAM Project (Diabetes Research, Education, and Action for Minorities): a
randomized trial of a community health worker intervention to improve diabetic management and
control among Bangladeshi adults in NYC." BMC Public Health 14: 177. PMC3933368.
LINKS
• PubMed: http://www.ncbi.nlm.nih.gov/pubmed/24548534
• DREAM Project: http://asian-health.med.nyu.edu/research/dream
• CSAAH Community Briefs: http://bit.ly/1kadOSM
Acknowledgements
The NYU Center for the Study of Asian American Health (CSAAH) was established in 2003 and is supported by the NIH National Institute of
Minority Health Disparities (NIMHD) cooperative agreement 2P60MD000538. The findings and conclusions in this report are those of the
authors and do not necessarily represent the official position of the agency listed above.
NYU Center for the Study of Asian American Health
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http://asian-health.med.nyu.edu/ | /NYU.CSAAH | @NYU_CSAAH