Hardly Reached

Integrating Social Needs Screening and CHWs in Primary Care: The Community Linkage to Care Program

Clin Pediatr (Phila). 2020 Jun;59(6):547-556. [Pubmed Abstract]

Fiori KP, Rehm CD, Sanderson D, Braganza S, Parsons A, Chodon T, Whiskey R, Bernard P, & Rinke ML

Abstract
Clinic-based social needs screening has been associated with increased access to social services and improved health outcomes. Using a pragmatic study design in an urban pediatric practice, we used logistic regression to identify factors associated with successful social service uptake. From December 2017 to November 2018, 4948 households were screened for social needs, and 20% self-reported at least one. Of the 287 households with unmet needs who were referred and interested in further assistance, 43% reported successful social service uptake. Greater than 4 outreach encounters (adjusted odds ratio = 1.92; 95% confidence interval = 1.06-3.49) and follow-up time >30 days (adjusted odds ratio = 0.43; 95% confidence interval = 0.25-0.73) were significantly associated with successful referrals. These…

Randomised clinical trial of community-based peer-led and psychologist-led group treatment for hoarding disorder

BJPsych Open. 2018 Jul 20;4(4):285-293. doi: 10.1192/bjo.2018.30. eCollection 2018 Jul. [Full Text Article]

Mathews CA, Mackin RS, Chou CY, Uhm SY, Bain LD, Stark SJ, Gause M, Vigil OR, Franklin J, Salazar M, Plumadore J, Smith LC, Komaiko K, Howell G, Vega E, Chan J, Eckfield MB, Tsoh JY, Delucchi K

Background
Treatment for hoarding disorder is typically performed by mental health professionals, potentially limiting access to care in underserved areas.

Aims
We aimed to conduct a non-inferiority trial of group peer-facilitated therapy (G-PFT) and group psychologist-led cognitive–behavioural therapy (G-CBT).

Method
We randomised 323 adults with hording disorder 15 weeks of G-PFT or 16 weeks of G-CBT and assessed at baseline, post-treatment and longitudinally (≥3 months post-treatment: mean 14.4 months, range 3–25). Predictors of treatment response were examined.

Results
G-PFT (effect size 1.20) was as effective as G-CBT (effect size 1.21; between-group…

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…