Accelerating Best Practices in Peer Support Around the World

Disparities

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

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…

9.27.16

Improving Diabetes Care and Outcomes with CHWs

Fam Pract. 2016 Oct;33(5):523-8. [Pubmed Abstract]

Improving diabetes care and outcomes with community health workers
Kane EP, Collinsworth AW, Schmidt KL, Brown RM, Snead CA, Barnes SA, Fleming NS, Walton JW

Background
Type II diabetes continues to be a major health problem in USA, particularly in minority populations. The Diabetes Equity Project (DEP), a clinic-based diabetes self-management and education program led by community health workers (CHWs), was designed to reduce observed disparities in diabetes care and outcomes in medically underserved, predominantly Hispanic communities.

Objective
The purpose of this study was to evaluate the impact of the DEP on patients’ clinical outcomes, diabetes knowledge, self-management skills, and quality of life.

Methods
The DEP was implemented in five community clinics from 2009 to 2013 and 885 patients completed at least two visits with the CHW. Student’s paired t-tests were used to compare baseline clinical indicators with…

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