Accelerating Best Practices in Peer Support Around the World

CHW

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…

10.14.19

Cost-effectiveness of a statewide public health intervention to reduce cardiovascular disease risk

BMC Public Health. 2019 Sep 6;19(1):1234. [Pubmed Abstract]

Smith L, Atherly A, Campbell J, Flattery N, Coronel S, Krantz M

Bacgkround
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.

Method
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…

7.10.19

Realizing the Value of CHWs — New Opportunities for Sustainable Financing

N Engl J Med. 2019 May 23;380(21):1990-1992. [Pubmed Abstract]

Lapidos A, Lapedis J, Heisler M

Health care financing in the US, especially since the passage of the Affordable Care Act (ACA) or “Obamacare,” has increased opportunities for financing peer support and community health worker (CHW) programs.  In this week’s Tuesday Tip, our colleague, Michele Heisler, and two of her other colleagues from the University of Michigan, Adrienne Lapidos and Jeremy Lapedis outline the case for routine financing of CHWs and several possible mechanisms and paths to accomplish this.

Opportunities include 2018 Medicare provisions to cover CHW and other nonmedical benefits especially for those with chronic diseases.  This follows earlier Medicaid provisions included in the ACA to cover CHW and other supportive services for those with mental health and chronic conditions.  Medicaid has also updated rules to encourage Medicaid MCOs to cover services including those addressing social…

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