{ "abstract": "Objective: Type 2 diabetes mellitus (T2DM) affects millions of Americans, and prediabetes significantly increases progression to T2DM. Community Health Workers (CHWs) may help prevent diabetes through behavioral interventions, but their effectiveness in real-world settings remains uncertain. We evaluated whether a CHW intervention prevents incident T2DM among adults with prediabetes. Research design and methods: Pragmatic, cluster-randomized controlled trial in primary care clinics at the Veterans Affairs NY Harbor Healthcare System (Manhattan) and Bellevue Hospital, New York City. The study included adults aged 18–75 years with HbA1c 5.7–6.4% and no prior diabetes or use of diabetes medications other than metformin. Primary care teams were cluster-randomized to a 12-month CHW program—health action plans, motivational interviewing, health education, and community referrals—versus usual care. The primary outcome was incident diabetes during up to 6 months’ follow-up after the 12-month intervention. Secondary outcomes were changes in HbA1c, weight, blood pressure, lipids, and health care utilization. Results: Incident diabetes occurred in 5.9% of intervention patients versus 4.3% of controls (risk difference 1.6%; 95% CI −3.68% to 4.10%). No significant differences were observed in HbA1c, weight, blood pressure, or lipids. The intervention group had more primary care encounters (77.6% vs 62.5%) and emergency department encounters (35.0% vs 29.1%). Conclusions: In this pragmatic trial, a 12-month CHW program did not reduce incident diabetes among adults with prediabetes but was associated with greater health care engagement (more primary care visits). More intensive or standardized CHW models should be tested to determine whether increased engagement translates into long-term metabolic benefit. Trial registration: The study protocol was registered at ClinicalTrials.gov (NCT03006666, 12/27/2016). https://clinicaltrials.gov/study/NCT03006666.", "abstract_shown": true, "affiliations": [ "Department of Population Health, NYU Grossman School of Medicine, New York, New York, United States of America.", "Department of Medicine, VA New York Harbor Healthcare System, New York, New York, United States of America.", "Department of Medicine, NYU Grossman School of Medicine, New York, New York, United States of America." ], "article_type": "Research Article", "arxiv": null, "author_total": 8, "authors": [ { "affs": [ 0, 1 ], "name": "Mark D Schwartz", "orcid": "0000-0002-7123-0060" }, { "affs": [ 0 ], "name": "Jiyuan Hu" }, { "affs": [ 0, 1 ], "name": "Scott E Sherman" }, { "affs": [ 0 ], "name": "Radhika Gore", "orcid": "0000-0001-7564-6808" }, { "affs": [ 0, 2 ], "name": "Natalie Levy" }, { "affs": [ 0, 2 ], "name": "Michael Tanner" }, { "affs": [ 0, 2 ], "name": "Michael Bergman" }, { "affs": [ 0 ], "name": "Nadia Islam" } ], "bibtex": "https://research.draconitic.com/paper/c5420ka1c87jv.bib", "cited_by": 0, "doi": "10.1371/journal.pone.0361464", "fulltext_url": "https://europepmc.org/articles/PMC13722175", "id": "c5420ka1c87jv", "issns": [ "1932-6203" ], "landing_url": "https://doi.org/10.1371/journal.pone.0361464", "language": "eng", "licence": "CC0-1.0", "licence_label": "CC0", "licence_source": "article", "licence_url": "https://creativecommons.org/publicdomain/zero/1.0/", "metadata_licence": null, "native_subjects": [ [ "heading", "Biochemistry" ], [ "heading", "Biology and Life Sciences" ], [ "heading", "Biology and life sciences" ], [ "heading", "Body Weight" ], [ "heading", "Cholesterol" ], [ "heading", "Diabetes Mellitus" ], [ "heading", "Diabetes Prevention" ], [ "heading", "Diabetes diagnosis and management" ], [ "heading", "Diagnostic medicine" ], [ "heading", "Endocrine Disorders" ], [ "heading", "Endocrinology" ], [ "heading", "Epidemiology" ], [ "heading", "HbA1c" ], [ "heading", "Health Care" ], [ "heading", "Hemoglobin" ], [ "heading", "Lipids" ], [ "heading", "Medical Conditions" ], [ "heading", "Medicine and Health Sciences" ], [ "heading", "Medicine and health sciences" ], [ "heading", "Metabolic Disorders" ], [ "heading", "Physiological Parameters" ], [ "heading", "Physiology" ], [ "heading", "Preventive Medicine" ], [ "heading", "Primary Care" ], [ "heading", "Proteins" ], [ "heading", "Public and Occupational Health" ], [ "heading", "Research Article" ], [ "heading", "Type 2 Diabetes" ], [ "plos", "/Biology and life sciences/Biochemistry/Lipids/Cholesterol" ], [ "plos", "/Biology and life sciences/Biochemistry/Proteins/Hemoglobin/HbA1c" ], [ "plos", "/Biology and life sciences/Physiology/Physiological parameters/Body weight" ], [ "plos", "/Medicine and health sciences/Diagnostic medicine/Diabetes diagnosis and management/HbA1c" ], [ "plos", "/Medicine and health sciences/Endocrinology/Endocrine disorders/Diabetes mellitus" ], [ "plos", "/Medicine and health sciences/Endocrinology/Endocrine disorders/Diabetes mellitus/Type 2 diabetes" ], [ "plos", "/Medicine and health sciences/Epidemiology" ], [ "plos", "/Medicine and health sciences/Health care/Primary care" ], [ "plos", "/Medicine and health sciences/Medical conditions/Metabolic disorders/Diabetes mellitus" ], [ "plos", "/Medicine and health sciences/Medical conditions/Metabolic disorders/Diabetes mellitus/Type 2 diabetes" ], [ "plos", "/Medicine and health sciences/Public and occupational health/Preventive medicine/Diabetes prevention" ] ], "openalex": null, "pdf_url": "https://europepmc.org/articles/PMC13722175?pdf=render", "pmcid": "PMC13722175", "pmid": "42961875", "published": "2026-10-30", "publisher": "Public Library of Science", "ris": "https://research.draconitic.com/paper/c5420ka1c87jv.ris", "sources": [ { "first_seen": "2026-10-31T12:20:55Z", "native_id": "10.1371/journal.pone.0361464", "source": "plos", "url": "https://doi.org/10.1371/journal.pone.0361464" }, { "first_seen": "2026-11-02T03:21:21Z", "native_id": "MED:42961875", "source": "europepmc", "url": "https://europepmc.org/article/MED/42961875" }, { "first_seen": "2026-11-03T12:22:44Z", "native_id": "PMC13722175", "source": "pmc", "url": "https://doi.org/10.1371/journal.pone.0361464" } ], "subjects": [ { "field": "biochemistry", "origin": "heading:Biochemistry", "subfield": "general" }, { "field": "biology", "origin": "heading:Biology and Life Sciences", "subfield": "general" }, { "field": "medicine", "origin": "plos:endocrinology", "subfield": "endocrinology-metabolism" }, { "field": "medicine", "origin": "plos:epidemiology", "subfield": "epidemiology-public-health" }, { "field": "medicine", "origin": "heading:Physiology", "subfield": "physiology" } ], "title": "Community health worker intervention to prevent incident type 2 diabetes: A cluster randomized trial", "title_text": "Community health worker intervention to prevent incident type 2 diabetes: A cluster randomized trial", "type": "peer-reviewed", "updated_at": "2026-11-03T12:22:44Z", "url": "https://research.draconitic.com/paper/c5420ka1c87jv", "venue": "PLOS One", "versions": [] }