Community Health Worker Impact on Chronic Disease Outcomes Within Primary Care Examined Using Electronic Health Records
To investigate community health worker (CHW) effects on chronic disease outcomes using electronic health records (EHRs). 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...
Gespeichert in:
| Veröffentlicht in: | American journal of public health (1971) 2017-10, Vol.107 (10), p.1668-1674 |
|---|---|
| Hauptverfasser: | , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 1674 |
|---|---|
| container_issue | 10 |
| container_start_page | 1668 |
| container_title | American journal of public health (1971) |
| container_volume | 107 |
| creator | Ingram, Maia Doubleday, Kevin Bell, Melanie L Lohr, Abby Murrieta, Lucy Velasco, Maria Blackburn, John Sabo, Samantha Guernsey de Zapien, Jill Carvajal, Scott C |
| description | To investigate community health worker (CHW) effects on chronic disease outcomes using electronic health records (EHRs).
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.
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.
Although patients' chronic disease indicators consistently improved, between-group models provided no additional evidence of impact. EHRs' evolution may elucidate CHW contributions moving forward. |
| doi_str_mv | 10.2105/AJPH.2017.303934 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5607666</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1942190542</sourcerecordid><originalsourceid>FETCH-LOGICAL-c490t-2ae5f958416ccdc9f152ae5a4b649b1a1bb21a83616542d5c73bda338ecb56413</originalsourceid><addsrcrecordid>eNpdkc9v0zAYhi0EYmVw54QsceHS4s-_El-QplDo0KRNiGlHy3Hc1SOxi-0A--9JSZmAky37eV99nx6EXgJZUSDi7dmnq82KEqhWjDDF-CO0AMFhSQivH6MFIYpMdyZP0LOc7wgBUAKeohNa11AxCgv0o4nDMAZf7vHGmb7s8E1MX13C58Pe2IJjwM0uxeAtfu-zM9nhy7HYOLiMb3zZ-YCvkh9MuseNSQ6vf5rBB9fh6-zDLV73zpY5fqz_7GxMXX6OnmxNn92L43mKrj-svzSb5cXlx_Pm7GJpuSJlSY0TWyVqDtLazqotiMOT4a3kqgUDbUvB1EyCFJx2wlas7QxjtbOtkBzYKXo39-7HdnCddaEk0-v9PLOOxut_f4Lf6dv4XQtJKinlVPDmWJDit9Hlogefret7E1wcswbFCK-U4nRCX_-H3sUxhWm9ieIUFBG_KTJTNsWck9s-DANEH6zqg1V9sKpnq1Pk1d9LPAT-aGS_ANzunro</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1942190542</pqid></control><display><type>article</type><title>Community Health Worker Impact on Chronic Disease Outcomes Within Primary Care Examined Using Electronic Health Records</title><source>MEDLINE</source><source>PAIS Index</source><source>Business Source Complete</source><source>PubMed Central</source><source>Alma/SFX Local Collection</source><creator>Ingram, Maia ; Doubleday, Kevin ; Bell, Melanie L ; Lohr, Abby ; Murrieta, Lucy ; Velasco, Maria ; Blackburn, John ; Sabo, Samantha ; Guernsey de Zapien, Jill ; Carvajal, Scott C</creator><creatorcontrib>Ingram, Maia ; Doubleday, Kevin ; Bell, Melanie L ; Lohr, Abby ; Murrieta, Lucy ; Velasco, Maria ; Blackburn, John ; Sabo, Samantha ; Guernsey de Zapien, Jill ; Carvajal, Scott C</creatorcontrib><description>To investigate community health worker (CHW) effects on chronic disease outcomes using electronic health records (EHRs).
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.
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.
Although patients' chronic disease indicators consistently improved, between-group models provided no additional evidence of impact. EHRs' evolution may elucidate CHW contributions moving forward.</description><identifier>ISSN: 0090-0036</identifier><identifier>EISSN: 1541-0048</identifier><identifier>DOI: 10.2105/AJPH.2017.303934</identifier><identifier>PMID: 28817321</identifier><language>eng</language><publisher>United States: American Public Health Association</publisher><subject>Adult ; Aged ; AJPH Research ; Body mass ; Body Mass Index ; Cholesterol ; Chronic Disease - therapy ; Chronic illnesses ; Community Health Workers - organization & administration ; Confidence intervals ; Diabetes ; Disease ; Disease management ; Disease prevention ; Electronic health records ; Electronic Health Records - statistics & numerical data ; Electronic medical records ; Female ; Glycated Hemoglobin ; Health Behavior ; Health care ; Health Care Facilities/Services ; Health informatics ; Health Professionals ; Health risks ; Health Service Delivery ; Hemoglobin ; High density lipoprotein ; Hispanics/Latinos ; Humans ; Hypertension ; Indexes ; Indicators ; Intervention ; Laboratories ; Laboratory tests ; Lipids - blood ; Lipoproteins ; Male ; Medical personnel ; Medical records ; Medical workers ; Mental Health ; Middle Aged ; Other Chronic Disease ; Patient Education as Topic ; Patient Navigation ; Patient Protection & Affordable Care Act 2010-US ; Patients ; Practice research ; Primaries & caucuses ; Primary care ; Primary Health Care - organization & administration ; Public health ; Public Health Practice ; Quality of service ; Self Care ; Statistical analysis ; Supervisors ; Teams ; Triglycerides ; Trust ; Ultrasonic testing ; Workers</subject><ispartof>American journal of public health (1971), 2017-10, Vol.107 (10), p.1668-1674</ispartof><rights>Copyright American Public Health Association Oct 2017</rights><rights>American Public Health Association 2017 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c490t-2ae5f958416ccdc9f152ae5a4b649b1a1bb21a83616542d5c73bda338ecb56413</citedby><cites>FETCH-LOGICAL-c490t-2ae5f958416ccdc9f152ae5a4b649b1a1bb21a83616542d5c73bda338ecb56413</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5607666/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5607666/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,27843,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28817321$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ingram, Maia</creatorcontrib><creatorcontrib>Doubleday, Kevin</creatorcontrib><creatorcontrib>Bell, Melanie L</creatorcontrib><creatorcontrib>Lohr, Abby</creatorcontrib><creatorcontrib>Murrieta, Lucy</creatorcontrib><creatorcontrib>Velasco, Maria</creatorcontrib><creatorcontrib>Blackburn, John</creatorcontrib><creatorcontrib>Sabo, Samantha</creatorcontrib><creatorcontrib>Guernsey de Zapien, Jill</creatorcontrib><creatorcontrib>Carvajal, Scott C</creatorcontrib><title>Community Health Worker Impact on Chronic Disease Outcomes Within Primary Care Examined Using Electronic Health Records</title><title>American journal of public health (1971)</title><addtitle>Am J Public Health</addtitle><description>To investigate community health worker (CHW) effects on chronic disease outcomes using electronic health records (EHRs).
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.
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.
Although patients' chronic disease indicators consistently improved, between-group models provided no additional evidence of impact. EHRs' evolution may elucidate CHW contributions moving forward.</description><subject>Adult</subject><subject>Aged</subject><subject>AJPH Research</subject><subject>Body mass</subject><subject>Body Mass Index</subject><subject>Cholesterol</subject><subject>Chronic Disease - therapy</subject><subject>Chronic illnesses</subject><subject>Community Health Workers - organization & administration</subject><subject>Confidence intervals</subject><subject>Diabetes</subject><subject>Disease</subject><subject>Disease management</subject><subject>Disease prevention</subject><subject>Electronic health records</subject><subject>Electronic Health Records - statistics & numerical data</subject><subject>Electronic medical records</subject><subject>Female</subject><subject>Glycated Hemoglobin</subject><subject>Health Behavior</subject><subject>Health care</subject><subject>Health Care Facilities/Services</subject><subject>Health informatics</subject><subject>Health Professionals</subject><subject>Health risks</subject><subject>Health Service Delivery</subject><subject>Hemoglobin</subject><subject>High density lipoprotein</subject><subject>Hispanics/Latinos</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Indexes</subject><subject>Indicators</subject><subject>Intervention</subject><subject>Laboratories</subject><subject>Laboratory tests</subject><subject>Lipids - blood</subject><subject>Lipoproteins</subject><subject>Male</subject><subject>Medical personnel</subject><subject>Medical records</subject><subject>Medical workers</subject><subject>Mental Health</subject><subject>Middle Aged</subject><subject>Other Chronic Disease</subject><subject>Patient Education as Topic</subject><subject>Patient Navigation</subject><subject>Patient Protection & Affordable Care Act 2010-US</subject><subject>Patients</subject><subject>Practice research</subject><subject>Primaries & caucuses</subject><subject>Primary care</subject><subject>Primary Health Care - organization & administration</subject><subject>Public health</subject><subject>Public Health Practice</subject><subject>Quality of service</subject><subject>Self Care</subject><subject>Statistical analysis</subject><subject>Supervisors</subject><subject>Teams</subject><subject>Triglycerides</subject><subject>Trust</subject><subject>Ultrasonic testing</subject><subject>Workers</subject><issn>0090-0036</issn><issn>1541-0048</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7TQ</sourceid><sourceid>8G5</sourceid><sourceid>BEC</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNpdkc9v0zAYhi0EYmVw54QsceHS4s-_El-QplDo0KRNiGlHy3Hc1SOxi-0A--9JSZmAky37eV99nx6EXgJZUSDi7dmnq82KEqhWjDDF-CO0AMFhSQivH6MFIYpMdyZP0LOc7wgBUAKeohNa11AxCgv0o4nDMAZf7vHGmb7s8E1MX13C58Pe2IJjwM0uxeAtfu-zM9nhy7HYOLiMb3zZ-YCvkh9MuseNSQ6vf5rBB9fh6-zDLV73zpY5fqz_7GxMXX6OnmxNn92L43mKrj-svzSb5cXlx_Pm7GJpuSJlSY0TWyVqDtLazqotiMOT4a3kqgUDbUvB1EyCFJx2wlas7QxjtbOtkBzYKXo39-7HdnCddaEk0-v9PLOOxut_f4Lf6dv4XQtJKinlVPDmWJDit9Hlogefret7E1wcswbFCK-U4nRCX_-H3sUxhWm9ieIUFBG_KTJTNsWck9s-DANEH6zqg1V9sKpnq1Pk1d9LPAT-aGS_ANzunro</recordid><startdate>201710</startdate><enddate>201710</enddate><creator>Ingram, Maia</creator><creator>Doubleday, Kevin</creator><creator>Bell, Melanie L</creator><creator>Lohr, Abby</creator><creator>Murrieta, Lucy</creator><creator>Velasco, Maria</creator><creator>Blackburn, John</creator><creator>Sabo, Samantha</creator><creator>Guernsey de Zapien, Jill</creator><creator>Carvajal, Scott C</creator><general>American Public Health Association</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>0U~</scope><scope>1-H</scope><scope>3V.</scope><scope>7RV</scope><scope>7TQ</scope><scope>7WY</scope><scope>7WZ</scope><scope>7X7</scope><scope>7XB</scope><scope>87Z</scope><scope>88A</scope><scope>88C</scope><scope>88E</scope><scope>88G</scope><scope>88I</scope><scope>88J</scope><scope>8AF</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8FL</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BEC</scope><scope>BENPR</scope><scope>BEZIV</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DHY</scope><scope>DON</scope><scope>DPSOV</scope><scope>DWQXO</scope><scope>FRNLG</scope><scope>FYUFA</scope><scope>F~G</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K60</scope><scope>K6~</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>KC-</scope><scope>L.-</scope><scope>L.0</scope><scope>LK8</scope><scope>M0C</scope><scope>M0R</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2L</scope><scope>M2M</scope><scope>M2O</scope><scope>M2P</scope><scope>M2R</scope><scope>M7P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PATMY</scope><scope>PQBIZ</scope><scope>PQBZA</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>PYCSY</scope><scope>Q9U</scope><scope>S0X</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>201710</creationdate><title>Community Health Worker Impact on Chronic Disease Outcomes Within Primary Care Examined Using Electronic Health Records</title><author>Ingram, Maia ; Doubleday, Kevin ; Bell, Melanie L ; Lohr, Abby ; Murrieta, Lucy ; Velasco, Maria ; Blackburn, John ; Sabo, Samantha ; Guernsey de Zapien, Jill ; Carvajal, Scott C</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c490t-2ae5f958416ccdc9f152ae5a4b649b1a1bb21a83616542d5c73bda338ecb56413</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Aged</topic><topic>AJPH Research</topic><topic>Body mass</topic><topic>Body Mass Index</topic><topic>Cholesterol</topic><topic>Chronic Disease - therapy</topic><topic>Chronic illnesses</topic><topic>Community Health Workers - organization & administration</topic><topic>Confidence intervals</topic><topic>Diabetes</topic><topic>Disease</topic><topic>Disease management</topic><topic>Disease prevention</topic><topic>Electronic health records</topic><topic>Electronic Health Records - statistics & numerical data</topic><topic>Electronic medical records</topic><topic>Female</topic><topic>Glycated Hemoglobin</topic><topic>Health Behavior</topic><topic>Health care</topic><topic>Health Care Facilities/Services</topic><topic>Health informatics</topic><topic>Health Professionals</topic><topic>Health risks</topic><topic>Health Service Delivery</topic><topic>Hemoglobin</topic><topic>High density lipoprotein</topic><topic>Hispanics/Latinos</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Indexes</topic><topic>Indicators</topic><topic>Intervention</topic><topic>Laboratories</topic><topic>Laboratory tests</topic><topic>Lipids - blood</topic><topic>Lipoproteins</topic><topic>Male</topic><topic>Medical personnel</topic><topic>Medical records</topic><topic>Medical workers</topic><topic>Mental Health</topic><topic>Middle Aged</topic><topic>Other Chronic Disease</topic><topic>Patient Education as Topic</topic><topic>Patient Navigation</topic><topic>Patient Protection & Affordable Care Act 2010-US</topic><topic>Patients</topic><topic>Practice research</topic><topic>Primaries & caucuses</topic><topic>Primary care</topic><topic>Primary Health Care - organization & administration</topic><topic>Public health</topic><topic>Public Health Practice</topic><topic>Quality of service</topic><topic>Self Care</topic><topic>Statistical analysis</topic><topic>Supervisors</topic><topic>Teams</topic><topic>Triglycerides</topic><topic>Trust</topic><topic>Ultrasonic testing</topic><topic>Workers</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ingram, Maia</creatorcontrib><creatorcontrib>Doubleday, Kevin</creatorcontrib><creatorcontrib>Bell, Melanie L</creatorcontrib><creatorcontrib>Lohr, Abby</creatorcontrib><creatorcontrib>Murrieta, Lucy</creatorcontrib><creatorcontrib>Velasco, Maria</creatorcontrib><creatorcontrib>Blackburn, John</creatorcontrib><creatorcontrib>Sabo, Samantha</creatorcontrib><creatorcontrib>Guernsey de Zapien, Jill</creatorcontrib><creatorcontrib>Carvajal, Scott C</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Social Sciences Premium Collection</collection><collection>Global News & ABI/Inform Professional</collection><collection>Trade PRO</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>PAIS Index</collection><collection>ABI/INFORM Collection</collection><collection>ABI/INFORM Global (PDF only)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>ABI/INFORM Global (Alumni Edition)</collection><collection>Biology Database (Alumni Edition)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Science Database (Alumni Edition)</collection><collection>Social Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ABI/INFORM Collection (Alumni Edition)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>Social Science Premium Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>eLibrary</collection><collection>ProQuest Central</collection><collection>Business Premium Collection</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>PAIS International</collection><collection>PAIS International (Ovid)</collection><collection>Politics Collection</collection><collection>ProQuest Central Korea</collection><collection>Business Premium Collection (Alumni)</collection><collection>Health Research Premium Collection</collection><collection>ABI/INFORM Global (Corporate)</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Business Collection (Alumni Edition)</collection><collection>ProQuest Business Collection</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Politics Collection</collection><collection>ABI/INFORM Professional Advanced</collection><collection>ABI/INFORM Professional Standard</collection><collection>ProQuest Biological Science Collection</collection><collection>ABI/INFORM Global</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Political Science Database</collection><collection>ProQuest Psychology</collection><collection>Research Library</collection><collection>Science Database</collection><collection>Social Science Database</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Environmental Science Database</collection><collection>ProQuest One Business</collection><collection>ProQuest One Business (Alumni)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>Environmental Science Collection</collection><collection>ProQuest Central Basic</collection><collection>SIRS Editorial</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>American journal of public health (1971)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ingram, Maia</au><au>Doubleday, Kevin</au><au>Bell, Melanie L</au><au>Lohr, Abby</au><au>Murrieta, Lucy</au><au>Velasco, Maria</au><au>Blackburn, John</au><au>Sabo, Samantha</au><au>Guernsey de Zapien, Jill</au><au>Carvajal, Scott C</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Community Health Worker Impact on Chronic Disease Outcomes Within Primary Care Examined Using Electronic Health Records</atitle><jtitle>American journal of public health (1971)</jtitle><addtitle>Am J Public Health</addtitle><date>2017-10</date><risdate>2017</risdate><volume>107</volume><issue>10</issue><spage>1668</spage><epage>1674</epage><pages>1668-1674</pages><issn>0090-0036</issn><eissn>1541-0048</eissn><abstract>To investigate community health worker (CHW) effects on chronic disease outcomes using electronic health records (EHRs).
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.
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.
Although patients' chronic disease indicators consistently improved, between-group models provided no additional evidence of impact. EHRs' evolution may elucidate CHW contributions moving forward.</abstract><cop>United States</cop><pub>American Public Health Association</pub><pmid>28817321</pmid><doi>10.2105/AJPH.2017.303934</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0090-0036 |
| ispartof | American journal of public health (1971), 2017-10, Vol.107 (10), p.1668-1674 |
| issn | 0090-0036 1541-0048 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5607666 |
| source | MEDLINE; PAIS Index; Business Source Complete; PubMed Central; Alma/SFX Local Collection |
| subjects | Adult Aged AJPH Research Body mass Body Mass Index Cholesterol Chronic Disease - therapy Chronic illnesses Community Health Workers - organization & administration Confidence intervals Diabetes Disease Disease management Disease prevention Electronic health records Electronic Health Records - statistics & numerical data Electronic medical records Female Glycated Hemoglobin Health Behavior Health care Health Care Facilities/Services Health informatics Health Professionals Health risks Health Service Delivery Hemoglobin High density lipoprotein Hispanics/Latinos Humans Hypertension Indexes Indicators Intervention Laboratories Laboratory tests Lipids - blood Lipoproteins Male Medical personnel Medical records Medical workers Mental Health Middle Aged Other Chronic Disease Patient Education as Topic Patient Navigation Patient Protection & Affordable Care Act 2010-US Patients Practice research Primaries & caucuses Primary care Primary Health Care - organization & administration Public health Public Health Practice Quality of service Self Care Statistical analysis Supervisors Teams Triglycerides Trust Ultrasonic testing Workers |
| title | Community Health Worker Impact on Chronic Disease Outcomes Within Primary Care Examined Using Electronic Health Records |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-05T08%3A02%3A18IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Community%20Health%20Worker%20Impact%20on%20Chronic%20Disease%20Outcomes%20Within%20Primary%20Care%20Examined%20Using%20Electronic%20Health%20Records&rft.jtitle=American%20journal%20of%20public%20health%20(1971)&rft.au=Ingram,%20Maia&rft.date=2017-10&rft.volume=107&rft.issue=10&rft.spage=1668&rft.epage=1674&rft.pages=1668-1674&rft.issn=0090-0036&rft.eissn=1541-0048&rft_id=info:doi/10.2105/AJPH.2017.303934&rft_dat=%3Cproquest_pubme%3E1942190542%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1942190542&rft_id=info:pmid/28817321&rfr_iscdi=true |