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. 2017 Oct;107(10):1668-1674.
doi: 10.2105/AJPH.2017.303934. Epub 2017 Aug 17.

Community Health Worker Impact on Chronic Disease Outcomes Within Primary Care Examined Using Electronic Health Records

Maia Ingram  1 , Kevin Doubleday  1 , Melanie L Bell  1 , Abby Lohr  1 , Lucy Murrieta  1 , Maria Velasco  1 , John Blackburn  1 , Samantha Sabo  1 , Jill Guernsey de Zapien  1 , Scott C Carvajal  1
Affiliations

Community Health Worker Impact on Chronic Disease Outcomes Within Primary Care Examined Using Electronic Health Records

Maia Ingram et al. Am J Public Health. 2017 Oct.

Abstract

Objectives: To investigate community health worker (CHW) effects on chronic disease outcomes using electronic health records (EHRs).

Methods: We examined EHRs of 32 147 patients at risk for chronic disease during 2012 to 2015. Variables included contact with clinic-based CHWs, vitals, and laboratory tests. We estimated a mixed model for all outcomes.

Results: Within-group findings showed statistically significant improvements in chronic disease indicators after exposure to CHWs. In health center 1, HbA1c (glycated hemoglobin) decreased 0.15 millimoles per mole (95% confidence interval [CI] = -0.24, -0.06), body mass index decreased 0.29 kilograms per meter squared (CI = -0.39, -0.20), and total cholesterol decreased 11.9 milligrams per deciliter (CI = -13.5, -10.2). In health center 2, HbA1c decreased 0.43 millimoles per mole (CI = -0.7, -0.17), body mass index decreased by 0.08 kilograms per meter squared (CI = -0.14, -0.02), and triglycerides decreased by 22.50 milligrams per deciliter (CI = -39.0, -6.0). Total cholesterol of 3.62 milligrams per deciliter (CI = -6.6, -0.6) in health center 1 was the only improvement tied to CHW contact.

Conclusions: Although patients' chronic disease indicators consistently improved, between-group models provided no additional evidence of impact. EHRs' evolution may elucidate CHW contributions moving forward.

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