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An expanded chronic care management approach to multiple chronic conditions in Hispanics using community health workers as community extenders in the Rio Grande Valley of Texas.
Lopez, Juliana Z; Lee, MinJae; Park, Soo K; Zolezzi, Maria E; Mitchell-Bennett, Lisa A; Yeh, Paul G; Perez, LuBeth; Heredia, Natalia I; McPherson, David D; McCormick, Joseph B; Reininger, Belinda M.
Afiliación
  • Lopez JZ; Brownsville Regional Campus, The University of Texas Health Science Center at Houston, Brownsville, TX, USA.
  • Lee M; Peter O'Donnell Jr. School of Public Health, University of Texas Southwestern, Dallas, TX, USA.
  • Park SK; Department of Biostatistics and Data Science, The University of Texas Health Science Center at Houston, Houston, TX, USA; Management, Policy and Community Health, The University of Texas Health Science Center at Houston, Houston, TX, USA.
  • Zolezzi ME; Brownsville Regional Campus, The University of Texas Health Science Center at Houston, Brownsville, TX, USA.
  • Mitchell-Bennett LA; Brownsville Regional Campus, The University of Texas Health Science Center at Houston, Brownsville, TX, USA.
  • Yeh PG; Brownsville Regional Campus, The University of Texas Health Science Center at Houston, Brownsville, TX, USA; Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston, Houston, TX, USA.
  • Perez L; Brownsville Regional Campus, The University of Texas Health Science Center at Houston, Brownsville, TX, USA.
  • Heredia NI; Department of Health Promotion & Behavioral Science, The University of Texas Health Science Center at Houston, Houston, TX, USA.
  • McPherson DD; Internal Medicine Cardiology, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA.
  • McCormick JB; Brownsville Regional Campus, The University of Texas Health Science Center at Houston, Brownsville, TX, USA.
  • Reininger BM; Brownsville Regional Campus, The University of Texas Health Science Center at Houston, Brownsville, TX, USA; Department of Health Promotion & Behavioral Science, The University of Texas Health Science Center at Houston, Houston, TX, USA. Electronic address: Belinda.M.Reininger@uth.tmc.edu.
Prev Med ; 184: 107975, 2024 Jul.
Article en En | MEDLINE | ID: mdl-38685533
ABSTRACT

INTRODUCTION:

The synergistic negative effects of type 2 diabetes (T2DM) and hypertension increases all-cause mortality and the medical complexity of management, which disproportionately impact Hispanics who face barriers to healthcare access. The Salud y Vida intervention was delivered to Hispanic adults living along the Texas-Mexico Border with comorbid poorly controlled T2DM and hypertension. The Salud y Vida multicomponent intervention incorporated community health workers (CHWs) into an expanded chronic care management model to deliver home-based follow-up visits and provided community-based diabetes self-management education.

METHODS:

We conducted multivariable longitudinal analysis to examine the longitudinal intervention effect on reducing systolic and diastolic blood pressure among 3806 participants enrolled between 2013 and 2019. Participants were compared according to their program participation as either higher (≥ 10 combined educational classes and CHW visits) or lower engagement (<10 encounters). Data was collected between 2013 and 2020.

RESULTS:

Baseline mean systolic and diastolic blood pressure were 138 and 81 mmHg respectively. There were overall improvements in systolic (-6.49; 95% CI = [-7.13, -5.85]; p < 0.001) and diastolic blood pressure (-3.97; 95% CI = [-4.37, -3.56]; p < 0.001). The higher engagement group had greater systolic blood pressure reduction at 3 months (adjusted mean difference = -1.8 mmHg; 95% CI = [-3.2, -0.3]; p = 0.016) and at 15 month follow-up (adjusted mean difference = -2.3 mmHg; 95% CI = [-4.2, -0.39]; p = 0.0225) compared to the lower engagement group.

CONCLUSION:

This intervention, tested and delivered in a real-world setting, provides an example of how CHW integration into an expanded chronic care model can improve blood pressure outcomes for individuals with co-morbidities.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Hispánicos o Latinos / Agentes Comunitarios de Salud / Diabetes Mellitus Tipo 2 / Hipertensión Límite: Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: Prev Med Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Hispánicos o Latinos / Agentes Comunitarios de Salud / Diabetes Mellitus Tipo 2 / Hipertensión Límite: Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: Prev Med Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos