Accelerating Best Practices in Peer Support Around the World

Primary Care

2.21.17

A pilot study of a Community Health Agent-led type 2 diabetes self-management program using MI-based approaches in a public primary care center in São Paulo, Brazil

do Valle Nascimento TM, Resnicow K, Nery M, Brentani A, Kaselitz E, Agrawal P, M and S, Heisler M

BMC Health Serv Res. 2017 Jan 13;17(1):32. [Pubmed Abstract]

Background
Rates of noncommunicable diseases (NCDs) such as type 2 diabetes are escalating in low and middle-income countries such as Brazil. Scalable primary care-based interventions are needed to improve self-management and clinical outcomes of adults with diabetes. This pilot study examines the feasibility, acceptability, and outcomes of training community health agents (CHAs) in Motivational Interviewing (MI)-based counseling for patients with poorly controlled diabetes in a primary care center in São Paulo, Brazil.

Methods
Nineteen salaried CHAs participated in 32 h of training in MI and behavioral action planning. With support from booster training sessions, they used these skills in their regular monthly home visits over a 6 month period with 57 diabetes patients with baseline HbA1cs > 7.0%. The primary…

9.27.16

Benchmarks for Reducing Emergency Department Visits and Hospitalizations Through CHWs Integrated Into Primary Care: A Cost-Benefit Analysis

Med Care. 2016 Aug 19. [Pubmed Abstract]

Benchmarks for Reducing Emergency Department Visits and Hospitalizations Through Community Health Workers Integrated Into Primary Care: A Cost-Benefit Analysis
Basu S, Jack HE, Arabadjis SD, Phillips RS

Background
Uncertainty about the financial costs and benefits of community health worker (CHW) programs remains a barrier to their adoption.

Objectives
To determine how much CHWs would need to reduce emergency department (ED) visits and associated hospitalizations among their assigned patients to be cost-neutral from a payer’s perspective.

Research Design
Using a microsimulation of patient health care utilization, costs, and revenues, we estimated what portion of ED visits and hospitalizations for different conditions would need to be prevented by a CHW program to fully pay for the program’s expenses. The model simulated CHW programs enrolling patients with a history of at least 1 ED visit for a chronic condition in the prior…

8.31.16

The Use of the Whole Primary-Care Team, Including CHWs, to Achieve Success in Increasing Colon Cancer Screening Rate

J Healthc Qual. 2016 Mar-Apr;38(2):76-83. [Pubmed Abstract]

The Use of the Whole Primary-Care Team, Including Community Health Workers, to Achieve Success in Increasing Colon Cancer Screening Rate
Arsenault PR, John LS, OʼBrien LM

Abstract
The National Colorectal Cancer Roundtable, an organization cofounded by the American Cancer Society and the Centers for Disease Control and Prevention, has set an aggressive goal to achieve an 80% colon cancer screening rate by the year 2018 to reduce the burden of colon cancer in the United States. This goal is in alignment with the primary care movement to focus on prevention and population health. However, colon cancer screening has been proven as an especially challenging preventive measure to get traction on with patients. Oakland Family Medicine, a medium primary care practice in Maine, has engaged in a quality improvement project to increase the colon cancer screening rates from 28%, when the project started, to 80.3%. To achieve…

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