Effectiveness of a Community Health Worker–led Diabetes Self-Management Education Program and Implications for CHW Involvement in Care Coordination Strategies

Collinsworth, Ashley; Vulimiri, Madhulika; Schmidt, Kathryn; Snead, Christine A.

doi:10.1177/0145721713504470

Cited by 50 publications

(65 citation statements)

References 20 publications

(25 reference statements)

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“…Previous studies have reported that CHWs can provide high-quality care and bridged the gap between patients and healthcare providers. 21 Furthermore, CHWs were found to fulfill a crucial role in smartphonebased hearing screening and management of noncommunicable diseases. 15,22 It has also been reported in a South African study that a trained lay telehealth clinic facilitator was effective to capture reliable images of the eardrum for accurate asynchronous diagnosis by an otolaryngologist.…”

Section: Discussionmentioning

confidence: 99%

Developmental Screening—Evaluation of an m-Health Version of the Parents Evaluation Developmental Status Tools

Maleka

Linde

Glascoe

et al. 2016

Telemedicine and e-Health

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Section: Discussionmentioning

confidence: 99%

Developmental Screening—Evaluation of an m-Health Version of the Parents Evaluation Developmental Status Tools

Maleka

Linde

Glascoe

et al. 2016

Telemedicine and e-Health

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“…We define CHW as a member of the patient’s community being utilized in any of the aforementioned capacities but not formally trained as a clinical or healthcare professional. Community health workers have been shown to augment patient knowledge [22], improve clinical outcomes [23, 24], reduce disparities [25], and decrease costs [26] in diabetes care. One study even showed increased Medicaid savings when CHWs specifically matched patient needs to local resources [4•].…”

Section: Methodsmentioning

confidence: 99%

Linking Community Resources in Diabetes Care: a Role for Technology?

Tung

Peek

2015

Curr Diab Rep

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Designing and implementing effective lifestyle modification strategies remains one of the great challenges in diabetes care. Historically, programs have focused on individual behavior change with little or no attempt to integrate change within the broader social framework or community context. However, these contextual factors have been shown to be associated with poor diabetes outcomes, particularly in low-income minority populations. Recent evidence suggests that one way to address these disparities is to match patient needs to existing community resources. Not only does this position patients to more quickly adapt behavior in a practical way, but this also refers patients back to their local communities where a support mechanism is in place to sustain healthy behavior. Technology offers a new and promising platform for connecting patients to meaningful resources (also referred to as “assets”). This paper summarizes several noteworthy innovations that use technology as a practical bridge between healthcare and community-based resources that promote diabetes self-care.

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“…Table 2 outlines CHW roles, using categories guided by previous literature. [41][42][43][44][45] Several patient-facing roles were common: outreach and navigation to increase access, education and coaching, social support, facilitating communication with the health care system, and linkage to referrals and community resources. Clinic-specific roles appeared to depend upon perception of patient need and the extent to which CHWs functioned as an extension into the community.…”

Section: Team Structure and Chw Rolesmentioning

confidence: 99%

Integrating Community Health Workers Into Medical Homes

Rogers

Manser

Cleary³

et al. 2018

Ann Fam Med

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PURPOSE Though evidence supports the value of community health workers (CHWs) in chronic disease self-management support, and authorities have called for expanding their roles within patient-centered medical homes (PCMHs), few PCMHs in Minnesota have incorporated these health workers into their care teams. We undertook a qualitative study to (1) identify facilitators and barriers to utilizing a CHW model among PCMHs in Minnesota, and (2) define roles played by this workforce within the PCMH team. METHODSWe conducted 51 semistructured, key-informant interviews of clinic leaders, clinicians, care coordinators, CHWs, and staff from 9 clinics (5 with community health workers, 4 without). Qualitative analysis consisted of thematic coding aligned with interview topics.RESULTS Four key conceptual themes emerged as facilitators and barriers to utilizing a CHW model: the presence of leaders with knowledge of CHWs who championed the model, a clinic culture that favored piloting innovation vs maintaining established care models, clinic prioritization of patients' nonmedical needs, and leadership perceptions of sustainability. These health care workers performed common and clinic-specific roles that included outreach, health education and coaching, community resource linkage, system navigation, and facilitating communication between clinician and patient.CONCLUSIONS We identified facilitators and barriers to adopting CHW roles as part of PCMH care teams in Minnesota and documented their roles being played in these settings. Our findings can be used when considering strategies to enhance utilization and integration of this emerging workforce. 2018;16:14-20. https://doi.org/10.1370/afm.2171. Ann Fam Med INTRODUCTIONC ommunity health workers (CHWs), trusted frontline health workers who have a close understanding of the community served, 1 can be valuable contributors to the team-based and patient-centered care promoted through the patient-centered medical home (PCMH) model. 2 CHWs complement roles played by traditional health professionals through culturally sensitive outreach, patient education, resource identification, case management, care coordination, and patient support. [3][4][5][6] Interventions by CHWs supporting chronic disease self-management and preventive services show improved health care utilization, knowledge, self-care, adherence, health outcomes, and quality of life, particularly when these workers are integrated into primary care teams. 4,[7][8][9][10][11][12][13][14][15][16][17][18][19][20] Their interventions are most often directed to and studied in underserved communities (racial and ethnic minority and low-income populations, federally qualified health care [FQHC] settings), where the integration of these workers show benefit. 3,4,12,[21][22][23] Health authorities have called for expanding interventions by CHWs among clinics serving these populations, and recent policies create a platform for greater community health worker integration. [24][25][26] Researchers have explored the experience of ...

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Effectiveness of a Community Health Worker–led Diabetes Self-Management Education Program and Implications for CHW Involvement in Care Coordination Strategies

Abstract: CHWs play a variety of roles in helping patients overcome barriers to diabetes control and can be successfully integrated into a health care system's care coordination strategy.

Cited by 50 publications

References 20 publications

Developmental Screening—Evaluation of an m-Health Version of the Parents Evaluation Developmental Status Tools

Developmental Screening—Evaluation of an m-Health Version of the Parents Evaluation Developmental Status Tools

Linking Community Resources in Diabetes Care: a Role for Technology?

Integrating Community Health Workers Into Medical Homes

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