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Community health worker support for disadvantaged patients with multiple chronic diseases: A randomized clinical trial

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  • Kangovi, S.
  • Mitra, N.
  • Grande, D.
  • Huo, H.
  • Smith, R.A.
  • Long, J.A.

Abstract

Objectives. To determine whether a community health worker (CHW) intervention improved outcomes in a low-income population with multiple chronic conditions. Methods. We conducted a single-blind, randomized clinical trial in Philadelphia, Pennsylvania (2013-2014). Participants (n = 302) were high-poverty neighborhood residents, uninsured or publicly insured, and diagnosed with 2 or more chronic diseases (diabetes, obesity, tobacco dependence, hypertension). All patients set a diseasemanagement goal. Patients randomly assigned to CHWs also received 6 months of support tailored to their goals and preferences. Results. Support from CHWs (vs goal-setting alone) led to improvements in several chronic diseases (changes in glycosylated hemoglobin: -0.4 vs 0.0; body mass index: -0.3 vs -0.1; cigarettes per day: -5.5 vs -1.3; systolic blood pressure: -1.8 vs -11.2; overall P = .08), self-rated mental health (12-item Short Form survey; 2.3 vs -0.2; P = .008), and quality of care (Consumer Assessment of Healthcare Providers and Systems; 62.9% vs 38%; P

Suggested Citation

  • Kangovi, S. & Mitra, N. & Grande, D. & Huo, H. & Smith, R.A. & Long, J.A., 2017. "Community health worker support for disadvantaged patients with multiple chronic diseases: A randomized clinical trial," American Journal of Public Health, American Public Health Association, vol. 107(10), pages 1660-1667.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2017.303985_1
    DOI: 10.2105/AJPH.2017.303985
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    Cited by:

    1. Andrew D Kerkhoff & Darpun Sachdev & Sara Mizany & Susy Rojas & Monica Gandhi & James Peng & Douglas Black & Diane Jones & Susana Rojas & Jon Jacobo & Valerie Tulier-Laiwa & Maya Petersen & Jackie Mar, 2020. "Evaluation of a novel community-based COVID-19 ‘Test-to-Care’ model for low-income populations," PLOS ONE, Public Library of Science, vol. 15(10), pages 1-18, October.
    2. Ibrahim Alananzeh & Heidi Lord & Ritin Fernandez, 2021. "Social Support for Arab People with Chronic Conditions: A Scoping Review," Clinical Nursing Research, , vol. 30(4), pages 380-391, May.
    3. Dorien Vanden Bossche & Sara Willems & Peter Decat, 2022. "Understanding Trustful Relationships between Community Health Workers and Vulnerable Citizens during the COVID-19 Pandemic: A Realist Evaluation," IJERPH, MDPI, vol. 19(5), pages 1-15, February.
    4. Cynthia F. Corbett & Kenn B. Daratha & Sterling McPherson & Crystal L. Smith & Michael S. Wiser & Brenda K. Vogrig & Sean M. Murphy & Roy Cantu & Dennis G. Dyck, 2021. "Patient Activation, Depressive Symptoms, and Self-Rated Health: Care Management Intervention Effects among High-Need, Medically Complex Adults," IJERPH, MDPI, vol. 18(11), pages 1-14, May.
    5. Flier, Jeffrey & Rhoads, Jared, 2018. "The US Health Provider Workforce: Determinants and Potential Paths to Enhancement," Working Papers 07662, George Mason University, Mercatus Center.
    6. Atheendar S Venkataramani & Rourke O’Brien & Gregory L Whitehorn & Alexander C Tsai, 2020. "Economic influences on population health in the United States: Toward policymaking driven by data and evidence," PLOS Medicine, Public Library of Science, vol. 17(9), pages 1-17, September.
    7. Li, Yan, 2022. "Social care for disabled elderly women in urban China: The roles of the community," Social Science & Medicine, Elsevier, vol. 314(C).
    8. Guey-Shin Shyu & Shinn-Jou Lin & Wei-Ta Fang & Bai-You Cheng, 2020. "How to Screen Suitable Service Improve Community Health Care Services by University Students in Taiwan," IJERPH, MDPI, vol. 17(15), pages 1-13, July.
    9. Aliza Moledina & Olivia Magwood & Eric Agbata & Jui‐Hsia Hung & Ammar Saad & Kednapa Thavorn & Ginetta Salvalaggio & Gary Bloch & David Ponka & Tim Aubry & Claire Kendall & Kevin Pottie, 2021. "A comprehensive review of prioritised interventions to improve the health and wellbeing of persons with lived experience of homelessness," Campbell Systematic Reviews, John Wiley & Sons, vol. 17(2), June.

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