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Am J Prev Med. 2017 Mar;52(3S3):S284-S289. doi: 10.1016/j.amepre.2016.08.034.

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

Author information

1
New York University School of Medicine, NYU-CUNY Prevention Research Center, New York, New York.
2
New York City Department of Health and Mental Hygiene, Long Island City, New York.
3
New York City Housing Authority, New York, New York.
4
Community Services Society, New York, New York.
5
City University of New York School of Public Health and Health Policy, NYU-CUNY Prevention Research Center, New York, New York.
6
New York University School of Medicine, NYU-CUNY Prevention Research Center, New York, New York. Electronic address: lorna.thorpe@nyumc.org.

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.

PMID:
28215382
PMCID:
PMC5656273
DOI:
10.1016/j.amepre.2016.08.034
[Indexed for MEDLINE]
Free PMC Article

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