Accelerating Best Practices in Peer Support Around the World

home visit

2.21.17

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]

Background
Advance care planning (ACP) is recommended for all persons to ensure that the care they receive aligns with their values and preferences.

Objective
To evaluate an ACP intervention developed to better meet the needs and priorities of persons with chronic diseases, including mild cognitive impairment.

Research Design
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.

Subjects
The 818 patients were 74.2 years old (mean); 78% women; 51% African American; 43% white.

Measures
Documentation of ACP conversation in electronic health record fields and health care utilization outcomes.

Results
In this target population ACP documentation rose from 3.4% (pre-CCA…

1.12.15

CHW Home Visits for Adults With Uncontrolled Asthma: The HomeBASE Trial

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

Importance
Asthma is often poorly controlled. Home visitation by community health workers (CHWs) to improve control among adults has not been adequately evaluated.

Objective
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.

Interventions
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
Primary prespecified…

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