563-P: A Community Health Worker–Led Hypertension and Diabetes Management Program for South Asians in Atlanta: The DREAM Atlanta Study

Background: South Asians are disproportionately affected by type 2 diabetes (DMII) and comorbid hypertension (HTN) , which increases the risk of stroke and myocardial infarction. In Atlanta, South Asians represent one of the fastest growing immigrant populations. Community health worker (CHW) interventions have been shown to improve chronic disease outcomes, yet few tailored interventions have addressed the high burden of cardiovascular disease among South Asians. Objective: To test the effectiveness of an evidence-based, CHW-led, and culturally-tailored HTN and DMII management program for South Asian adults with DMII and comorbid HTN. Methods and Study Design: Randomized-Waitlist Controlled Trial Setting/intervention: The treatment group received 5 group virtual DMII and HTN education sessions as well as 2 one-on-one goal setting sessions. The waitlist control group received 3 group virtual sessions at the end of study. Measures: Primary outcomes included feasibility, acceptability, and change in BP control (systolic blood pressure (SBP) <130 and diastolic blood pressure (DBP) <80) . Secondary outcomes included changes in glycated hemoglobin (HbA1c) , weight, diabetes self-efficacy, healthy eating, and physical activity. Results: A total of 199 South Asian adults were randomized to treatment or control groups. At 6-month follow-up, 40.2% of the treatment group had controlled BP, compared to 24.2% of the control group (p=0.020) . Absolute change in mean SBP and DBP was significantly greater for the treatment group vs. control group. Weight change was -4.8lbs in the treatment group, compared to +0.6lbs in the control group (p=0.007) . The intervention had an overall retention of 95% (treatment = 92, control=91) . Conclusions: A culturally-tailored CHW-led intervention is feasible, acceptable, and can significantly improve diabetes and HTN among South Asians. Further study will evaluate the implementation and scalability of the intervention. Disclosure M.K.Shah: None. L.Wyatt: None. C.C.Gibbs: None. S.Mammen: None. F.M.Mohsin: None. N.Islam: None. Funding NIMHD: K23 MD015088-and 3U54MD000538-17S1