rural
Peer Support Intervention Improves Pain-Related Outcomes Among Rural Adults With Diabetes and Chronic Pain at 12-Month Follow-Up
J Rural Health. 2020 Mar 2. doi: 10.1111/jrh.12422. [Pubmed Abstract]
Khodneva Y, Richman J, Andreae S, Cherrington A, Safford MM
Purpose
Adults with diabetes mellitus (DM) suffer often from chronic pain, yet evidence-based interventions for comorbid pain and DM are scarce. We tested the effect of a peer-led cognitive behavioral training (CBT) intervention on pain self-efficacy (PSE), pain intensity, and pain-related functional limitations (PRFL) in adults with DM, 1 year after trial initiation.
Methods
The yearlong “Living Healthy” cluster-randomized trial included 230 residents of rural Alabama with DM, who reported pain in the past month; communities were treated as clusters. Intervention participants received a peer-delivered 8-session structured CBT intervention in the context of diabetes self-management; attention control arm participants received a peer-delivered 8-session general health education program. Outcomes included PSE (Arthritis Self-Efficacy Scale, range…
Observational Stepped-Wedge Analysis of a CHW-Led Intervention for Diabetes and Hypertension in Rural Mexico
BMJ Open. 2020 Mar 8;10(3):e034749. [Pubmed Abstract]
Worster DT, Franke MF, Bazúa R, Flores H, García Z, Krupp J, Maza J, Palazuelos L, Rodríguez K, Newman PM, Palazuelos D
Objectives
There is emerging interest and data supporting the effectiveness of community health workers (CHWs) in non-communicable diseases (NCDs) in low/middle-income countries (LMICs). This study aimed to determine whether a CHW-led intervention targeting diabetes and hypertension could improve markers of clinical disease control in rural Mexico.
Design and setting
A prospective observational stepped-wedge study was conducted across seven communities in rural Chiapas, Mexico from March 2014 to April 2018.
Participants
149 adults with hypertension and/or diabetes.
Intervention
This study was conducted in the context of the programmatic roll-out of an accompaniment-based CHW-led intervention designed to complement comprehensive primary care for adults with diabetes and/or hypertension….
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…
