A cohort review approach evaluating community health worker programs in New York City, 2015-2017

The objective of this study was to describe how a cohort review approach was applied as an evaluation framework for a community health worker intervention among adult residents in 5 public housing developments in New York City in 2015-2017. The cohort review approach involved systematically monitoring participants engaged in the Harlem Health Advocacy Partners program during a given time period ("cohort") to assess individual outcomes and program performance. We monitored participation status (completed, still active, disengaged, on leave, or died) and health outcomes. In this example of a cohort review, levels of enrollment and program disengagement were higher in cohort 1 than in cohort 2. For 6-month health outcomes, the percentage of participants with hypertension who had controlled blood pressure was static in cohort 1 and improved significantly in cohort 2. The percentage of participants with diabetes who self-reported controlled hemoglobin A1c increased significantly in cohort 1 at 6-month follow- up. The cohort approach highlighted important outcome successes and identified workload challenges affecting recruitment and retention.