Accelerating Best Practices in Peer Support Around the World

chronic disease

4.9.18

CHW Support for Disadvantaged Patients With Multiple Chronic Diseases: A Randomized Clinical Trial

Am J Public Health. 2017 Oct;107(10):1660-1667. [Pubmed Abstract]

Kangovi S, Mitra N, Grande D, Huo H, Smith RA, Long JA

Objectives
To determine whether a community health worker (CHW) intervention improved outcomes in a low-income population with multiple chronic conditions.

Methods
We conducted a single-blind, randomized clinical trial in Philadelphia, Pennsylvania (2013-2014). Participants (n = 302) were high-poverty neighborhood residents, uninsured or publicly insured, and diagnosed with 2 or more chronic diseases (diabetes, obesity, tobacco dependence, hypertension). All patients set a disease-management goal. Patients randomly assigned to CHWs also received 6 months of support tailored to their goals and preferences.

Results
Support from CHWs (vs goal-setting alone) led to improvements in several chronic diseases (changes in glycosylated hemoglobin: -0.4 vs 0.0; body mass index: -0.3 vs -0.1; cigarettes per day: -5.5 vs -1.3; systolic blood pressure: -1.8 vs…

4.9.18

Evaluation of a multi-faceted diabetes care program including community-based peer educators in Takeo province, Cambodia, 2007-2013

PLoS One. 2017 Sep 25;12(9):e0181582. [Pubmed Abstract]

Taniguchi D, LoGerfo J, van Pelt M, Mielcarek B, Huster K, Haider M, Thomas B

Introduction
Early detection and treatment for diabetes are essential for reducing disability and death from the disease. Finding effective screening and treatment for individuals living with diabetes in resource-limited countries is a challenge. MoPoTsyo, a Cambodian non-governmental organization, addressed this gap by utilizing a multi-pronged approach with community-based peer educators, access to laboratory procedures, local outpatient medical consultation, and a revolving drug fund. This study evaluated outcomes of MoPoTsyo’s diabetes program in Takeo Province by assessing glycemic and blood pressure outcomes for individuals diagnosed with diabetes over a 24-month follow-up period between 2007-2013.

Methods
This is a retrospective cohort analysis of records without a comparison group. We calculated the mean fasting blood glucose (FBG)…

4.9.18

RCT of a CHW Self-Management Support Intervention Among Low-Income Adults With Diabetes, Seattle, Washington, 2010-2014

Prev Chronic Dis. 2017 Feb 9;14:E15. [Pubmed Abstract]

Nelson K, Taylor L, Silverman J, Kiefer M, Hebert P, Lessler D, Krieger J

Introductions
Community health workers (CHWs) can improve diabetes outcomes; however, questions remain about translating research findings into practical low-intensity models for safety-net providers. We tested the effectiveness of a home-based low-intensity CHW intervention for improving health outcomes among low-income adults with diabetes.

Methods
Low-income patients with glycated hemoglobin A1c (HbA1c) of 8.0% or higher in the 12 months before enrollment from 3 safety-net providers were randomized to a 12-month CHW-delivered diabetes self-management intervention or usual care. CHWs were based at a local health department. The primary outcome was change in HbA1c from baseline enrollment to 12 months; secondary outcomes included blood pressure and lipid levels, quality of life, and health care use.

Results
The change in HbA1c in the…

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