A Place-Based Community Health Worker Program: Feasibility and Early Outcomes, New York City, 2015

Priscilla M. Lopez, Nadia Islam, Alexis Feinberg, Christa Myers, Lois Seidl, Elizabeth Drackett, Lindsey Riley, Andrea Mata, Juan Pinzon, Elisabeth Benjamin, Katarzyna Wyka, Rachel Dannefer, Javier Lopez, Chau Trinh-Shevrin, Karen Aletha Maybank, Lorna Thorpe

Research output: Contribution to journalArticle

Abstract

Introduction This study examined feasibility of a place-based community health worker (CHW) and health advocate (HA) initiative in five public housing developments selected for high chronic disease burden and described early outcomes. Methods This intervention was informed by a mixed-method needs assessment performed December 2014–January 2015 (representative telephone survey, n=1,663; six focus groups, n=55). Evaluation design was a non-randomized, controlled quasi-experiment. Intake and 3-month follow-up data were collected February–December 2015 (follow-up response rate, 93%) on 224 intervention and 176 comparison participants, and analyzed in 2016. All participants self-reported diagnoses of hypertension, diabetes, or asthma. The intervention consisted of chronic disease self-management and goal setting through six individual CHW-led health coaching sessions, instrumental support, and facilitated access to insurance/clinical care navigation from community-based HAs. Feasibility measures included CHW service satisfaction and successful goal setting. Preliminary outcomes included clinical measures (blood pressure, BMI); disease management behaviors and self-efficacy; and preventive behaviors (physical activity). Results At the 3-month follow-up, nearly all intervention participants reported high satisfaction with their CHW (90%) and HA (76%). Intervention participants showed significant improvements in self-reported physical activity (p=0.005) and, among hypertensive participants, self-reported routine blood pressure self-monitoring (p=0.013) compared with comparison participants. No improvements were observed in self-efficacy or clinical measures at the 3-month follow-up. Conclusions Housing-based initiatives involving CHW and HA teams are acceptable to public housing residents and can be effectively implemented to achieve rapid improvements in physical activity and chronic disease self-management. At 3-month assessment, additional time and efforts are required to improve clinical outcomes.

Original languageEnglish (US)
Pages (from-to)S284-S289
JournalAmerican Journal of Preventive Medicine
Volume52
Issue number3
DOIs
StatePublished - Mar 1 2017

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Disease Management
Public Housing
Chronic Disease
Health
Self Efficacy
Exercise
Self Care
Community Health Services
Ambulatory Blood Pressure Monitoring
Needs Assessment
Feasibility Studies
Insurance
Focus Groups
Telephone
Asthma
Blood Pressure
Hypertension

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health

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A Place-Based Community Health Worker Program : Feasibility and Early Outcomes, New York City, 2015. / Lopez, Priscilla M.; Islam, Nadia; Feinberg, Alexis; Myers, Christa; Seidl, Lois; Drackett, Elizabeth; Riley, Lindsey; Mata, Andrea; Pinzon, Juan; Benjamin, Elisabeth; Wyka, Katarzyna; Dannefer, Rachel; Lopez, Javier; Trinh-Shevrin, Chau; Aletha Maybank, Karen; Thorpe, Lorna.

In: American Journal of Preventive Medicine, Vol. 52, No. 3, 01.03.2017, p. S284-S289.

Research output: Contribution to journalArticle

Lopez, PM, Islam, N, Feinberg, A, Myers, C, Seidl, L, Drackett, E, Riley, L, Mata, A, Pinzon, J, Benjamin, E, Wyka, K, Dannefer, R, Lopez, J, Trinh-Shevrin, C, Aletha Maybank, K & Thorpe, L 2017, 'A Place-Based Community Health Worker Program: Feasibility and Early Outcomes, New York City, 2015', American Journal of Preventive Medicine, vol. 52, no. 3, pp. S284-S289. https://doi.org/10.1016/j.amepre.2016.08.034
Lopez, Priscilla M. ; Islam, Nadia ; Feinberg, Alexis ; Myers, Christa ; Seidl, Lois ; Drackett, Elizabeth ; Riley, Lindsey ; Mata, Andrea ; Pinzon, Juan ; Benjamin, Elisabeth ; Wyka, Katarzyna ; Dannefer, Rachel ; Lopez, Javier ; Trinh-Shevrin, Chau ; Aletha Maybank, Karen ; Thorpe, Lorna. / A Place-Based Community Health Worker Program : Feasibility and Early Outcomes, New York City, 2015. In: American Journal of Preventive Medicine. 2017 ; Vol. 52, No. 3. pp. S284-S289.
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abstract = "Introduction This study examined feasibility of a place-based community health worker (CHW) and health advocate (HA) initiative in five public housing developments selected for high chronic disease burden and described early outcomes. Methods This intervention was informed by a mixed-method needs assessment performed December 2014–January 2015 (representative telephone survey, n=1,663; six focus groups, n=55). Evaluation design was a non-randomized, controlled quasi-experiment. Intake and 3-month follow-up data were collected February–December 2015 (follow-up response rate, 93{\%}) on 224 intervention and 176 comparison participants, and analyzed in 2016. All participants self-reported diagnoses of hypertension, diabetes, or asthma. The intervention consisted of chronic disease self-management and goal setting through six individual CHW-led health coaching sessions, instrumental support, and facilitated access to insurance/clinical care navigation from community-based HAs. Feasibility measures included CHW service satisfaction and successful goal setting. Preliminary outcomes included clinical measures (blood pressure, BMI); disease management behaviors and self-efficacy; and preventive behaviors (physical activity). Results At the 3-month follow-up, nearly all intervention participants reported high satisfaction with their CHW (90{\%}) and HA (76{\%}). Intervention participants showed significant improvements in self-reported physical activity (p=0.005) and, among hypertensive participants, self-reported routine blood pressure self-monitoring (p=0.013) compared with comparison participants. No improvements were observed in self-efficacy or clinical measures at the 3-month follow-up. Conclusions Housing-based initiatives involving CHW and HA teams are acceptable to public housing residents and can be effectively implemented to achieve rapid improvements in physical activity and chronic disease self-management. At 3-month assessment, additional time and efforts are required to improve clinical outcomes.",
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AU - Lopez, Priscilla M.

AU - Islam, Nadia

AU - Feinberg, Alexis

AU - Myers, Christa

AU - Seidl, Lois

AU - Drackett, Elizabeth

AU - Riley, Lindsey

AU - Mata, Andrea

AU - Pinzon, Juan

AU - Benjamin, Elisabeth

AU - Wyka, Katarzyna

AU - Dannefer, Rachel

AU - Lopez, Javier

AU - Trinh-Shevrin, Chau

AU - Aletha Maybank, Karen

AU - Thorpe, Lorna

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N2 - Introduction This study examined feasibility of a place-based community health worker (CHW) and health advocate (HA) initiative in five public housing developments selected for high chronic disease burden and described early outcomes. Methods This intervention was informed by a mixed-method needs assessment performed December 2014–January 2015 (representative telephone survey, n=1,663; six focus groups, n=55). Evaluation design was a non-randomized, controlled quasi-experiment. Intake and 3-month follow-up data were collected February–December 2015 (follow-up response rate, 93%) on 224 intervention and 176 comparison participants, and analyzed in 2016. All participants self-reported diagnoses of hypertension, diabetes, or asthma. The intervention consisted of chronic disease self-management and goal setting through six individual CHW-led health coaching sessions, instrumental support, and facilitated access to insurance/clinical care navigation from community-based HAs. Feasibility measures included CHW service satisfaction and successful goal setting. Preliminary outcomes included clinical measures (blood pressure, BMI); disease management behaviors and self-efficacy; and preventive behaviors (physical activity). Results At the 3-month follow-up, nearly all intervention participants reported high satisfaction with their CHW (90%) and HA (76%). Intervention participants showed significant improvements in self-reported physical activity (p=0.005) and, among hypertensive participants, self-reported routine blood pressure self-monitoring (p=0.013) compared with comparison participants. No improvements were observed in self-efficacy or clinical measures at the 3-month follow-up. Conclusions Housing-based initiatives involving CHW and HA teams are acceptable to public housing residents and can be effectively implemented to achieve rapid improvements in physical activity and chronic disease self-management. At 3-month assessment, additional time and efforts are required to improve clinical outcomes.

AB - Introduction This study examined feasibility of a place-based community health worker (CHW) and health advocate (HA) initiative in five public housing developments selected for high chronic disease burden and described early outcomes. Methods This intervention was informed by a mixed-method needs assessment performed December 2014–January 2015 (representative telephone survey, n=1,663; six focus groups, n=55). Evaluation design was a non-randomized, controlled quasi-experiment. Intake and 3-month follow-up data were collected February–December 2015 (follow-up response rate, 93%) on 224 intervention and 176 comparison participants, and analyzed in 2016. All participants self-reported diagnoses of hypertension, diabetes, or asthma. The intervention consisted of chronic disease self-management and goal setting through six individual CHW-led health coaching sessions, instrumental support, and facilitated access to insurance/clinical care navigation from community-based HAs. Feasibility measures included CHW service satisfaction and successful goal setting. Preliminary outcomes included clinical measures (blood pressure, BMI); disease management behaviors and self-efficacy; and preventive behaviors (physical activity). Results At the 3-month follow-up, nearly all intervention participants reported high satisfaction with their CHW (90%) and HA (76%). Intervention participants showed significant improvements in self-reported physical activity (p=0.005) and, among hypertensive participants, self-reported routine blood pressure self-monitoring (p=0.013) compared with comparison participants. No improvements were observed in self-efficacy or clinical measures at the 3-month follow-up. Conclusions Housing-based initiatives involving CHW and HA teams are acceptable to public housing residents and can be effectively implemented to achieve rapid improvements in physical activity and chronic disease self-management. At 3-month assessment, additional time and efforts are required to improve clinical outcomes.

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