Accelerating Best Practices in Peer Support Around the World

Disparities

5.21.20

Integrating Social Needs Screening and CHWs in Primary Care: The Community Linkage to Care Program

Clin Pediatr (Phila). 2020 Jun;59(6):547-556. [Pubmed Abstract]

Fiori KP, Rehm CD, Sanderson D, Braganza S, Parsons A, Chodon T, Whiskey R, Bernard P, & Rinke ML

Abstract
Clinic-based social needs screening has been associated with increased access to social services and improved health outcomes. Using a pragmatic study design in an urban pediatric practice, we used logistic regression to identify factors associated with successful social service uptake. From December 2017 to November 2018, 4948 households were screened for social needs, and 20% self-reported at least one. Of the 287 households with unmet needs who were referred and interested in further assistance, 43% reported successful social service uptake. Greater than 4 outreach encounters (adjusted odds ratio = 1.92; 95% confidence interval = 1.06-3.49) and follow-up time >30 days (adjusted odds ratio = 0.43; 95% confidence interval = 0.25-0.73) were significantly associated with successful referrals. These…

2.5.20

A Novel Intervention for High-Need, High-Cost Medicaid Patients: a Study of ECHO Care

J Gen Intern Med. 2020 Jan;35(1):21-27. doi: 10.1007/s11606-019-05206-0. Epub 2019 Oct 30. [Pubmed Abstract]

Komaromy M, Bartlett J, Gonzales-van Horn SR, Zurawski A, Kalishman SG, Zhu Y, Davis HT, Ceballos V, Sun X, Jurado M, Page K, Hamblin A, Arora S

Background
A small number of high-need patients account for a disproportionate amount of Medicaid spending, yet typically engage little in outpatient care and have poor outcomes.

Objective
To address this issue, we developed ECHO (Extension for Community Health Outcomes) Care™, a complex care intervention in which outpatient intensivist teams (OITs) provided care to high-need high-cost (HNHC) Medicaid patients. Teams were supported using the ECHO model™, a continuing medical education approach that connects specialists with primary care providers for case-based mentoring to treat complex diseases.

Design
Using an interrupted time series analysis of Medicaid claims data, we measured healthcare utilization and…

10.14.19

Home Visit Intervention Promotes Lifestyle Changes: Results of an RCT in Mexican Americans

Am J Prev Med. 2019 Sep 27. pii: S0749-3797(19)30307-1. [Pubmed Abstract]

Vidoni ML, Lee M, Mitchell-Bennett L, Reininger BM

Introduction
Hispanic populations are less likely that other ethnicities to meet physical activity guidelines. Community health worker (CHW) outreach is an effective delivery method for behavior change messages owing to shared culture, language, and life experience. This study examined the efficacy of a CHW-delivered intervention, Tu Salud ¡Si Cuenta! (Your Health Matters!) at Home Intervention, to promote physical activity among Mexican Americans.

Study Design
RCT.

Setting and Participants
Mexican Americans living along the Texas-Mexico border from June 2010 to April 2013.

Intervention
Eligible adults were randomized into intervention (n=250) or standard care (n=250). Intervention participants received 6 monthly CHW visits that included education, motivation, and support for lifestyle changes. Standard care was potentially exposed to a…

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