Randomised clinical trial of community-based peer-led and psychologist-led group treatment for hoarding disorder
BJPsych Open. 2018 Jul 20;4(4):285-293. doi: 10.1192/bjo.2018.30. eCollection 2018 Jul. [Full Text Article]
Mathews CA, Mackin RS, Chou CY, Uhm SY, Bain LD, Stark SJ, Gause M, Vigil OR, Franklin J, Salazar M, Plumadore J, Smith LC, Komaiko K, Howell G, Vega E, Chan J, Eckfield MB, Tsoh JY, Delucchi K
Treatment for hoarding disorder is typically performed by mental health professionals, potentially limiting access to care in underserved areas.
We aimed to conduct a non-inferiority trial of group peer-facilitated therapy (G-PFT) and group psychologist-led cognitive–behavioural therapy (G-CBT).
We randomised 323 adults with hording disorder 15 weeks of G-PFT or 16 weeks of G-CBT and assessed at baseline, post-treatment and longitudinally (≥3 months post-treatment: mean 14.4 months, range 3–25). Predictors of treatment response were examined.
G-PFT (effect size 1.20) was as effective as G-CBT (effect size 1.21; between-group…
BMC Public Health. 2019 Sep 6;19(1):1234. [Pubmed Abstract]
Smith L, Atherly A, Campbell J, Flattery N, Coronel S, Krantz M
The cost-effectiveness of community health worker (CHW)-based cardiovascular disease (CVD) risk-reduction interventions is not well established. Colorado Heart Healthy Solutions is a CHW-based intervention designed to reduce modifiable CVD risk factors. This program has previously demonstrated success, but the cost-effectiveness is unknown. CHW-based interventions are potentially attractive complements to healthcare delivery because laypersons implement the intervention at a lower cost relative to medical care and may be attractive in rural settings with limited clinical resources.
CHWs performed screenings and provided ongoing participant support within predominantly rural communities. A point-of-service software tool was used to generate 10-year Framingham CVD risk scores and assist CHWs to make medical referrals and provide ongoing…
Am J Public Health. 2017 Oct;107(10):1660-1667. [Pubmed Abstract]
Kangovi S, Mitra N, Grande D, Huo H, Smith RA, Long JA
To determine whether a community health worker (CHW) intervention improved outcomes in a low-income population with multiple chronic conditions.
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.
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…