Community health worker impact on chronic disease outcomes within primary care examined using electronic health records

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

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

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

Original languageEnglish (US)
Pages (from-to)1668-1674
Number of pages7
JournalAmerican journal of public health
Volume107
Issue number10
DOIs
StatePublished - Oct 2017

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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