Literature DB >> 19802379

Strategies to improve chronic disease management in seven metro Boston community health centers.

Chima D Ndumele1, Beverley E Russell, John Z Ayanian, Bruce E Landon, Thomas Keegan, A James O'Malley, Leroi S Hicks.   

Abstract

BACKGROUND: The Community, Health Center, and Academic Medicine Partnership Project (CHAMPP) is a partnership between medical researchers, community health centers (CHCs), and a community advisory committee focused on reducing cardiovascular morbidity related to hypertension and diabetes for non-Hispanic Black and Hispanic populations in Boston, Massachusetts.
OBJECTIVE: We conducted site visits at seven participating CHCs, located in Boston. The visits were to solicit health center staff opinions about site-specific barriers and enabling factors for optimum preventative cardiovascular care for racial/ethnic minority patients receiving hypertension and diabetes care at their centers.
METHODS: Site visits included a tour of each health center and a series of directed interviews with center personnel. Site visit notes were reviewed to identify themes that emerged during the course of each site visit. A summary matrix was developed for each health center, which included information regarding the most salient and persistent themes of the visit.
RESULTS: Site visits uncovered several patient-, provider-, CHC-, and community-based factors that either facilitate or hinder optimal care of chronic disease patients. Commonly referenced barriers included the need for improved patient adherence to provider recommendations; insufficient time for providers to address complex health issues presented by patients and the need for a broader range of healthier food options in surrounding communities. Interactive patient groups and community health workers (CHWs) have been well received when implemented.
CONCLUSION: Recommendations included adopting case management as a part of usual care for chronic disease patients; additionally, widespread implementation of CHWs may to provide a platform for more comprehensive care for patients.

Entities:  

Keywords:  Community-based participatory research; cardiovascular diseases; diabetes mellitus; endocrine system diseases; health disparities; health outcomes

Mesh:

Year:  2009        PMID: 19802379      PMCID: PMC2747109          DOI: 10.1353/cpr.0.0080

Source DB:  PubMed          Journal:  Prog Community Health Partnersh        ISSN: 1557-0541


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