Impact of CHWs on Elderly Patients’ Advance Care Planning and Health Care Utilization: Moving the Dial
Litzelman DK, Inui TS, Griffin WJ, Perkins A, Cottingham AH, Schmitt-Wendholt KM, Ivy SS
Med Care. 2016 Nov 21. [Pubmed Abstract]
Advance care planning (ACP) is recommended for all persons to ensure that the care they receive aligns with their values and preferences.
To evaluate an ACP intervention developed to better meet the needs and priorities of persons with chronic diseases, including mild cognitive impairment.
A year-long, pre-post intervention using lay community health workers [care coordinator assistants (CCAs)] trained to conduct and document ACP conversations with patients during home health visits with pre-post evaluation.
The 818 patients were 74.2 years old (mean); 78% women; 51% African American; 43% white.
Documentation of ACP conversation in electronic health record fields and health care utilization outcomes.
In this target population ACP documentation rose from 3.4% (pre-CCA…
JAMA Intern Med. 2015 Jan 1;175(1):109-17. [Pubmed Abstract]
Community Health Worker Home Visits for Adults With Uncontrolled Asthma: The HomeBASE Trial Randomized Clinical Trial
Krieger J, Song L, Philby M
Asthma is often poorly controlled. Home visitation by community health workers (CHWs) to improve control among adults has not been adequately evaluated.
To test the hypothesis that CHW home visits for adults with uncontrolled asthma improve outcomes relative to usual care.
Design, Setting, and Participants
Randomized parallel group study with 1-year follow-up, conducted 2008 through 2011 at homes of low-income adults aged 18 to 65 years with uncontrolled asthma living in King County, Washington.
The CHWs provided a mean of 4.9 home visits during a 1-year period to assess asthma control, self-management, and home environment and to support asthma self-management practices.
Main Outcomes and Measures