home visit
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…
Innovative Home Visit Models Associated With Reductions In Costs, Hospitalizations, And Emergency Department Use
Health Aff (Millwood). 2017 Mar 1;36(3):425-432. [Pubmed Abstract]
Ruiz S, Snyder LP, Rotondo C, Cross-Barnet C, Colligan EM, Giuriceo K
Abstract
While studies of home-based care delivered by teams led by primary care providers have shown cost savings, little is known about outcomes when practice-extender teams-that is, teams led by registered nurses or lay health workers-provide home visits with similar components (for example, care coordination and education). We evaluated findings from five models funded by Health Care Innovation Awards of the Centers for Medicare and Medicaid Services. Each model used a mix of different components to strengthen connections to primary care among fee-for-service Medicare beneficiaries with multiple chronic conditions; these connections included practice-extender home visits. Two models achieved significant reductions in Medicare expenditures, and three models reduced utilization in the form of emergency department visits, hospitalizations, or…
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…
