Clinic-Community Partnerships Clinics, community organizations, and other groups can develop partnerships to extend the range and variety of opportunities and supports for self management. These reflect the reality that diabetes management takes place in daily life, not in clinics. The Diabetes Initiative identified key characteristics of effective partnerships and developed tools to help track their progression and improve outcomes. Healthy Coping Managing negative emotions is important in diabetes management.
A range of strategies to address these include support groups, self management classes, supportive community health workers, counselors on the diabetes care team, medication, and as-needed referral care. All individuals can benefit from improving their coping skills, and all 14 Diabetes Initiative grantees incorporated this aspect of self management into their programs. Topics include: Understanding diabetes and diabetes treatment.
Healthy eating. Being physically active. Taking medicine. Checking your blood sugar. Reducing your risk for other health problems. Learning to cope with stress, depression, and other concerns. Top of Page. The SME programs that follow are for people with any chronic health condition. About the Program The Chronic Disease Self-Management Program is an interactive workshop for people with all types of chronic conditions. Program Details This interactive workshop meets for 2.
The program is also available in Spanish. Subjects covered include: Techniques to deal with problems such as frustration, fatigue, pain, and isolation. Appropriate exercise for maintaining and improving strength, flexibility, and endurance. Appropriate use of medications. Communicating effectively with family, friends, and health professionals.
Managing depression. Better breathing techniques. Relaxation techniques. Healthy eating habits. Making good decisions about your health.
How to evaluate new treatments. Family Practice ;33 5 Cost-effectiveness of community health workers in controlling diabetes epidemic on the US—Mexico border. Public Health ; 7 Economic evaluation of Indigenous health worker management of poorly controlled type 2 diabetes in north Queensland.
Med J Aust ; 5 Diabetes Care. Additional studies were identified via suggestions from subject matter experts and hand-searches from reference lists. Studies published in English from beginning of database through May , limited to countries with high income economies as defined by the World Bank were searched and screened for inclusion.
This literature search was performed to find studies on the economics of interventions engaging community health workers for the prevention of cardiovascular disease, prevention of diabetes, and management of diabetes. Ten bibliographic databases were searched during August , using the terms listed below.
Publications listed from inception of databases to August, were covered, and the types of documents retrieved by the search included journal articles, books, book chapters, reports, and conference papers.
In addition, reference lists of included studies were screened and subject matter experts were consulted for additional studies that may have been missed. Search terms and strategies were adjusted for each database, based on controlled and uncontrolled vocabularies and software.
Community health workers: orientation for state health departments: ASTHO state technical assistance presentation. Arlington VA ; C3 Project. The Community health worker core consensus C3 project: recommendations on CHW roles, skills, and qualities.
Community health worker national workforce study. Department of Health and Human Services. Rockville MD ; Randomized controlled trial of a community health worker self-management support intervention among low-income adults with diabetes, Seattle, Washington, — Prev Chronic Dis ; The following considerations are drawn from studies included in the evidence review, the broader literature, and expert opinion.
Create an Account. You are here Home » Systematic Review. The CPSTF has related findings for interventions that engage community health workers: Diabetes prevention Cardiovascular disease prevention. Screening and health education. For example, community health workers might teach patients how to plan healthy meals to improve glucose levels, or how to use a medication diary to track adherence 38 studies.
Outreach, enrollment, and information. Community health workers reach out to individuals and families who are eligible for medical services, help them apply for these services, and provide them with proactive follow-up and monitoring, such as appointment reminders and home visits. Member of care delivery team.
Community health workers partner with patients and licensed providers, such as physicians and nurses, to improve coordinated care and support for patients. Patient navigation. Community health workers help individuals and families navigate complex medical service systems and processes to increase their access to care. Community organizers.
Community health workers may facilitate self-directed change and community development by serving as liaisons between communities and healthcare systems. For example, community health workers might serve as liaisons between the community and those implementing an intervention to ensure program materials are culturally appropriate and specific to their community 1 study. Improvements were seen for self-reported lifestyle changes i.
Results were mixed for cardiovascular disease risk factors and weight-related outcomes. Mean fasting blood glucose: median decrease of Healthcare Use Studies reported decreases in emergency department visits among patients in intervention groups when compared to those in control groups. Cardiovascular Disease Risk Factors Mean total cholesterol: median decrease of 8. Additional Findings In 17 of the included studies, community health workers were used in team-based care. Interventions that engaged community health workers in team-based care decreased systolic blood pressure by 2.
Based on results, the CPSTF finding should be applicable to interventions that engage community health workers in the following settings and populations: Adults with type 2 diabetes Women and men Hispanics, African-Americans, and Asians Low-income and low-education populations Urban and rural environments Clinics, community, and home settings. How effective are large-scale programs i. What are the challenges or barriers that impact the recruitment and retention of male clients?
How will changes in Centers for Medicaid CMS reimbursement rules affect the use of community health workers and the roles and services they provide? How effective are interventions among younger and older adult populations? What are the long-term effects on diabetes-related complications and health outcomes? How can community health workers be more engaged as outreach, enrollment, and information agents, patient navigators, and community organizers?
What are the roles and effects of community health workers in a team-based care environment? Included studies had the greatest suitability of design individual randomized control trials [15 studies], group randomized controlled trials [5 studies], before-after with a comparison group [5 studies], other design with concurrent comparison groups [5 studies] ; moderate suitability of design retrospective cohort [1 study] ; and least suitability of design before-after without a comparison group [13 studies].
Studies were conducted in the United States 39 studies , the United Kingdom 3 studies , and Australia 2 studies. Studies were conducted in urban 21 studies , rural 6 studies , or mixed 3 studies areas; 14 studies did not report this information. Included studies evaluated interventions in clinics e. In the included studies, CHWs served adults ages 18—64 years old 32 studies , older adults ages 65 years and older 1 study , adults 18 years and older 3 studies , or patients of all ages 3 studies ; 5 studies did not report this information.
Participants had type 2 diabetes 31 studies , type 1 or 2 diabetes 6 studies , or diabetes of unspecified type 7 studies. In the 27 team studies, the other team members were most often physicians 19 studies , nurses 15 studies , or registered dietitians 12 studies.
Community health workers met a median of 3. These included the following: Providing culturally appropriate information 37 studies Building individual and community capacity 33 studies Coaching 32 studies Coordinating care or case management 17 studies.
Economics of community health workers for chronic disease: findings from Community Guide systematic reviews. American Journal of Preventive Medicine. Economic Review No content is available for this section.
Effectiveness Review Content is in development. The checklist is designed to be a conversation facilitator and can help to establish and strengthen relationships between community health workers and health care providers looking to address a range of health issues.
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