Original Investigation

Structured Telehealth Community Health Worker–Clinician Feedback and Diabetes Outcomes

JAMA Internal Medicine 10.1001/jamainternmed.2026.1917

June 08, 2026 at 11:00 AM EDT

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Can a multidimensional, telehealth-based intervention with a structured participant–community health worker (CHW)–clinician feedback loop improve diabetes outcomes across diverse clinical sites compared with usual clinical care?In this randomized clinical trial of 257 low-income White Hispanic adults with type 2 diabetes, the CHW-delivered intervention improved hemoglobin A levels compared with usual care. CHWs addressed 87.2% of participant concerns through the feedback loop.In this trial, the intervention significantly improved diabetes outcomes, possibly by reducing fragmentation through the feedback loop, providing a scalable approach for low-income settings.

Corresponding Author: Elizabeth M. Vaughan, DO, MPH, Department of Internal Medicine, University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555 (emvaughan316@gmail.com).

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