Research Briefs
CHWs and the Affordable Care Act: An Opportunity for a Research, Advocacy, and Policy Agenda
To date, there has been limited policy guidance, support, or evidence on how best to integrate CHWs into the health system on a large scale. The Affordable Care Act, through several provisions, provides a unique opportunity to create a unified framework for workforce integration and wider utilization of CHWs. This review identifies four major opportunities to further the research, advocacy, and policy agenda for CHWs and recent evidence for each of the opportunities. [Abstract]
Feasibility and Evaluation of a Pilot CHW Intervention to Reduce Hospital Readmissions
A randomized quality improvement intervention was conducted at an academic medical center in Boston, MA and 10 affiliated primary care practices. The participants (n=423) were discharged to home and had one of five risk factors for readmission within 30 days. Roughly 70% of patients received at least one post-discharge CHW call and only 38% received at least calls as intended. While readmission rates were lower among CHW patients (15.4%) compared to usual care (17.9%), the difference was statistically significant. An ongoing RCT based on this pilot will provide further insight into this approach. [Abstract]
The Impact of Medicaid Peer Support Utilization on Cost
The purpose of this study was to fill gaps in the literature related to peer support programs and cost: lack of comparison groups, small sample sizes, and the availability of research examining utilization of Medicaid mental health services. Peer support was associated with $5,991 higher total Medicaid cost (p<.01), $2,100 higher prescription drug cost (p<.01), $5,116 higher professional services cost (p<.01), and $1,225 lower facility cost (p<.01). While Medicaid financed peer support is not cost-saving, it effectively supports the principles of self-direction and recovery from serious mental illness. State policy makers must weigh the potential higher cost associated with peer support programs with efforts to redesign the delivery of mental health services. [Abstract]
Comparative Effectiveness of Peer Leaders and CHWs in Diabetes Self-management Support: Results of a RCT
Peers for Progress grantees at the University of Michigan compared a peer leader (PL) versus a CHW telephone outreach intervention in sustaining improvements in HbA1c over 12 months after a 6-month diabetes self-management education program. Both low-cost maintenance programs led by either a PL or a CHW maintained improvements in key patient-reported diabetes outcomes, but the PL intervention may have additional benefit in sustaining clinical improvements beyond 12 months. [Abstract]
A Demonstration of Peer Support for Ugandan Adults with Type 2 Diabetes
A Peers for Progress demonstration grant reports that a short-term (4 months) peer support program was a feasible intervention to improve diabetes care in rural Uganda. Participants were successfully recruited and retained, and they experienced positive behavioral and physiologic outcomes (HbA1c, diastolic blood pressure, and eating behaviors). Elements of the intervention were sustained 18 months after the intervention. [Abstract]
Back to top |
