Desenvolvimento, implementação e avaliação de uma capacitação sobre o manejo do Diabetes Mellitus tipo 2 aplicada aos Agentes Comunitários de Saúde do interior do Amazonas

Abstract

The role of Community Health Workers (CHWs) is strategic in the follow-up of people with type 2 Diabetes Mellitus (T2DM), especially in remote regions. However, gaps remain in the training of these professionals for managing chronic diseases, highlighting the need for continuous, interdisciplinary, and culturally appropriate capacity-building strategies. This study aimed to develop, implement, and evaluate a theoretical–practical training program for CHWs in the management of T2DM in the interior of Amazonas, Brazil. This was an implementation study conducted in Iranduba AM, within the project “CHW-led intervention for T2DM management in the interior of Amazonas.” A total of 34 CHWs participated, randomly allocated into an intervention group (n=17) and a control group (n=17). The training, grounded in Goal-Setting Theory, included 20 video lessons delivered via WhatsApp, supporting materials, and practical activities with users diagnosed with T2DM. Data collection involved pre- and post-training questionnaires, satisfaction assessments, and focus groups. Overall adherence was 97.45%, with higher participation in the theoretical component (98.66%) compared to the practical component (40.24%). CHWs reported good acceptance of the program, emphasizing the use of diverse materials and inclusive strategies. However, no statistically significant differences were found between groups (p=0.1753), with only limited improvement in performance. The RE-AIM framework analysis showed positive results in reach and adoption, but only moderate effectiveness. Difficulties related to diet, laboratory testing, and glycemic control were identified as major barriers. In conclusion, the training was feasible and well-accepted, but requires improvement and continuity to strengthen Primary Health Care in vulnerable contexts.