Accelerating Best Practices in Peer Support Around the World

Health Disparity

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…

10.21.15

Strategies to Improve the Integration of CHWs Into Health Care Teams

Prev Chronic Dis. 2015 Sep 17;12:E154. [Pubmed Abstract]

Strategies to Improve the Integration of Community Health Workers Into Health Care Teams: “A Little Fish in a Big Pond”
Allen CG, Escoffery C, Satsangi A, Brownstein JN

Introduction
The Patient Protection and Affordable Care Act acknowledges the value of community health workers (CHWs) as frontline public health workers. Consequently, growing attention has been placed on promoting CHWs as legitimate partners to provide support to health care teams and patients in the prevention, management, and control of chronic disease, particularly among diverse populations and high-need individuals.

Methods
Using a mixed-methods research approach, we investigated the integration of CHWs into health care teams from the CHW perspective. We conducted a survey of 265 CHWs and interviews with 23 CHWs to better understand and describe their experience and their perceived opportunities and challenges regarding their integration within…

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