BACKGROUND: The role of community health workers (CHWs) has expanded from outreach and education to working within a clinical team in a primary care setting. AIM: To improve self-management among patients with type 2 diabetes incorporating CHWs as members of a clinical team. METHODS: A cohort of 114 patients with type 2 diabetes enrolled in 2007 participated in a teambased self-management intervention with followup in 2008. The study assessed whether significant changes occurred in clinical, patient satisfaction and activation measures after the intervention compared with baseline. The programme was located at St Luke's Health Care Center in San Francisco, California, in an ethnically diverse neighbourhood serving predominantly low-income Latino patients. Clinical outcomes measured included glycosylated haemoglobin (HbA1c), low-density lipoprotein (LDL), blood pressure and total cholesterol. A Patient Activation Measure (PAM) assessed self-management. Both provider and patient experiences with the programme were also assessed using a patient telephone satisfaction survey and provider focus group. RESULTS: The majority of patients were Latino Spanish speaking women on public insurance. Thirty-one patients participated in a telephone satisfaction survey. Six providers participated in a focus group to assess satisfaction with care. HealthFirst had a positive impact, improving HbA1c among high-risk patients with type 2 diabetes (HbA1c≥ 9.0) and maintaining glycaemic control among patients with controlled glycaemic level at baseline (HbA1c<7.0). In addition, LDL, total cholesterol and self-management outcomes significantly improved. Ninety-seven percent of patients were satisfied with the CHWs' support. Overall, providers' comfort level in referring patients to CHWs was very high. CONCLUSIONS: Physician-CHW partnership had a positive impact on patients' self-management skills and clinical outcomes. Patients and physicians also had higher satisfaction with overall care. With appropriate training, CHWs can collaborate as team members with primary care providers and with non-medical providers to improve the quality of care.
BACKGROUND: The role of community health workers (CHWs) has expanded from outreach and education to working within a clinical team in a primary care setting. AIM: To improve self-management among patients with type 2 diabetes incorporating CHWs as members of a clinical team. METHODS: A cohort of 114 patients with type 2 diabetes enrolled in 2007 participated in a teambased self-management intervention with followup in 2008. The study assessed whether significant changes occurred in clinical, patient satisfaction and activation measures after the intervention compared with baseline. The programme was located at St Luke's Health Care Center in San Francisco, California, in an ethnically diverse neighbourhood serving predominantly low-income Latino patients. Clinical outcomes measured included glycosylated haemoglobin (HbA1c), low-density lipoprotein (LDL), blood pressure and total cholesterol. A Patient Activation Measure (PAM) assessed self-management. Both provider and patient experiences with the programme were also assessed using a patient telephone satisfaction survey and provider focus group. RESULTS: The majority of patients were Latino Spanish speaking women on public insurance. Thirty-one patients participated in a telephone satisfaction survey. Six providers participated in a focus group to assess satisfaction with care. HealthFirst had a positive impact, improving HbA1c among high-risk patients with type 2 diabetes (HbA1c≥ 9.0) and maintaining glycaemic control among patients with controlled glycaemic level at baseline (HbA1c<7.0). In addition, LDL, total cholesterol and self-management outcomes significantly improved. Ninety-seven percent of patients were satisfied with the CHWs' support. Overall, providers' comfort level in referring patients to CHWs was very high. CONCLUSIONS: Physician-CHW partnership had a positive impact on patients' self-management skills and clinical outcomes. Patients and physicians also had higher satisfaction with overall care. With appropriate training, CHWs can collaborate as team members with primary care providers and with non-medical providers to improve the quality of care.
Authors: Andrea L Cherrington; April A Agne; Yolanda Lampkin; Annie Birl; Tanya C Shelton; Alfredo Guzman; James H Willig Journal: J Ambul Care Manage Date: 2015 Oct-Dec
Authors: Elizabeth A Rogers; Sarah Turcotte Manser; Joan Cleary; Anne M Joseph; Eileen M Harwood; Kathleen T Call Journal: Ann Fam Med Date: 2018-01 Impact factor: 5.166
Authors: Lewis L Hsu; Nancy S Green; E Donnell Ivy; Cindy E Neunert; Arlene Smaldone; Shirley Johnson; Sheila Castillo; Amparo Castillo; Trevor Thompson; Kisha Hampton; John J Strouse; Rosalyn Stewart; TaLana Hughes; Sonja Banks; Kim Smith-Whitley; Allison King; Mary Brown; Kwaku Ohene-Frempong; Wally R Smith; Molly Martin Journal: Am J Prev Med Date: 2016-07 Impact factor: 5.043
Authors: Maia Ingram; Kevin Doubleday; Melanie L Bell; Abby Lohr; Lucy Murrieta; Maria Velasco; John Blackburn; Samantha Sabo; Jill Guernsey de Zapien; Scott C Carvajal Journal: Am J Public Health Date: 2017-08-17 Impact factor: 9.308
Authors: Chandra Y Osborn; K Rivet Amico; Noemi Cruz; Rafael Perez-Escamilla; Seth C Kalichman; Ann A O'Connell; Scott A Wolf; Jeffrey D Fisher Journal: Transl Behav Med Date: 2011-09 Impact factor: 3.046
Authors: Mona AuYoung; Ninez A Ponce; O Kenrik Duru; Arturo Vargas Bustamante; Carol M Mangione; Hector P Rodriguez Journal: J Immigr Minor Health Date: 2016-12