Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2017 Oct;107(10):1660-1667.
doi: 10.2105/AJPH.2017.303985. Epub 2017 Aug 17.

Community Health Worker Support for Disadvantaged Patients With Multiple Chronic Diseases: A Randomized Clinical Trial

Shreya Kangovi  1 , Nandita Mitra  1 , David Grande  1 , Hairong Huo  1 , Robyn A Smith  1 , Judith A Long  1
Affiliations
Randomized Controlled Trial

Community Health Worker Support for Disadvantaged Patients With Multiple Chronic Diseases: A Randomized Clinical Trial

Shreya Kangovi et al. Am J Public Health. 2017 Oct.

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 disease-management 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 < .001), while reducing hospitalization at 1 year by 28% (P = .11). There were no differences in patient activation or self-rated physical health.

Conclusions: A standardized CHW intervention improved chronic disease control, mental health, quality of care, and hospitalizations and could be a useful population health management tool for health care systems.

Trial registration: clinicaltrials.gov identifier: NCT01900470.

PubMed Disclaimer

Figures

FIGURE 1—
FIGURE 1—
CONSORT Diagram Showing the Flow of Participants Through the Trial: Philadelphia, PA, July 12, 2013–October 15, 2014 Note. CHW = community health worker.
See this image and copyright information in PMC

References

    1. Anderson G. Chronic Care: Making the Case for Ongoing Care. Princeton, NJ: Robert Wood Johnson Foundation; 2010.
    1. Chronic conditions among Medicare beneficiaries, chart book. Baltimore, MD: Centers for Medicare and Medicaid Services; 2011.
    1. Parekh AK, Meyers DS. The strategic framework on multiple chronic conditions. Med Care. 2014;52(suppl 3):S1–S2. - PubMed
    1. Lochner KA, Goodman RA, Posner S, Parekh A. Multiple chronic conditions among Medicare beneficiaries: state-level variations in prevalence, utilization, and cost, 2011. Medicare Medicaid Res Rev. 2013;3(3):pii:mmrr.003.03.b02. - PMC - PubMed
    1. Long JA, Jahnle EC, Richardson DM, Loewenstein G, Volpp KG. Peer mentoring and financial incentives to improve glucose control in African American veterans: a randomized trial. Ann Intern Med. 2012;156(6):416–424. - PMC - PubMed

Publication types

Substances

Associated data