Abstract P016: Preventing Heart Disease, Stroke, and Related Chronic Diseases in the Mississippi Delta Region: Clinical Community Health Worker Initiative
Background: Community Health Workers (CHW) are increasingly being used to address chronic disease prevention, but knowledge of their use in underserved rural settings is limited. CHW can be instrumental in linking underserved populations to clinical care and navigating the health care system. We report on the influence of our Clinical Community Health Worker Initiative (CCHWI) intervention program on clinical risk factors for heart disease and stroke in the Mississippi Delta region.
Methods: Patients diagnosed with hypertension, diabetes or high cholesterol, and ≥18 years and consented to participate in the CCHWI were referred to a CHW for follow-up. CHW conducts an initial home visit, a follow-up phone call 7 to 10 days after the initial visit, a second home visit after 30-45 days and a subsequent recurring 90-day follow-up home visit. CHW activities include appointment scheduling and transportation arrangement, interpretation of health information, demonstrating proper procedures in monitoring blood pressure and blood glucose and encouraging patients to keep monitoring logs, assisting patients in documenting questions or concerns regarding medication and/or treat regimens for next doctors visit, assisting patients in setting nutrition target and goals, explaining the benefits of changing lifestyle habits, performing height, weight, and blood pressure measurements, encouraging patient to enroll in chronic disease self-management classes, and arranging referral for counseling to tobacco cessation treatment programs. Clinical data from 432 participants contacted by CHWs during home visits and phone calls from August 2012 to August 2014 were evaluated. We used paired t tests to assess changes from baseline for the following clinical measures: blood pressure, hemoglobin A1c, total blood cholesterol, high density lipoprotein cholesterol, low density lipoprotein (LDL) cholesterol, triglycerides, and body mass index.
Results: Mean age of participants was 57.6 (range 20-89) years; 71.1% were female, and 91.9% were black. The majority of the participants were diagnosed with hypertension (82.4%) and diabetes (72.0%) and more than half (57.2%) with high cholesterol. One in five (21.1%) participants had only one condition, 46.3% had two conditions and a third (32.6%) had all three conditions. We observed statistically significant improvements (baseline vs most recent value) for diastolic blood pressure (p=0.0045), total cholesterol (p=0.0014), LDL cholesterol (p=0.0117), and triglycerides (p=0.0255).
Conclusion: The use of CHW may help improve heart disease and stroke clinical risk factors among rural underserved populations.
Author Disclosures: V. Mendy: None. T. Walls: None. A. Cole: None. C. Dove: None. A. Bilbro: None.
- © 2015 by American Heart Association, Inc.