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      A Community Health Worker–Led Community–Clinical Linkage Model to Address Emotional Well-Being Outcomes Among Latino/a People on the US–Mexico Border

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          Abstract

          Introduction

          Compared with their non-Hispanic White counterparts, Latino/a people have limited access to health resources that might improve their emotional well-being. Interventions that prioritize the Latino/a population, address social determinants of health, and decrease health disparities are needed. The objective of this study was to describe a community–clinical linkage intervention led by community health workers (CHWs) in 3 Latino/a populations along the US–Mexico border.

          Methods

          Researchers at the Arizona Prevention Research Center conducted the Linking Individual Needs to Community and Clinical Services (LINKS) study during 2017–2018. Clinic-based CHWs referred participants to community-based CHWs who met with participants monthly for 6 months to assess participant needs, provide support for emotional well-being, and link them to resources. Two community-based CHWs collaborated to maximize participant care; they also administered an emotional well-being questionnaire at baseline and at 3-month and 6-month follow-up. We estimated changes in emotional well-being outcomes.

          Results

          Scores for social support, perceived hopefulness, and quality-of-life measures among 189 LINKS participants increased significantly during the study period, especially among men and participants with low baseline scores. For each of the 3 outcomes, the standardized change was approximately 0.28 per 3 months of intervention, a decrease of more than half an SD (0.56) during 6 months of follow-up.

          Conclusion

          A CHW-led community–clinical linkage intervention can result in positive emotional well-being outcomes. We encourage policy makers, funders, and public health practitioners to further investigate such interventions as a solution to reduce disparities in emotional well-being.

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          Most cited references23

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          Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support.

          Research electronic data capture (REDCap) is a novel workflow methodology and software solution designed for rapid development and deployment of electronic data capture tools to support clinical and translational research. We present: (1) a brief description of the REDCap metadata-driven software toolset; (2) detail concerning the capture and use of study-related metadata from scientific research teams; (3) measures of impact for REDCap; (4) details concerning a consortium network of domestic and international institutions collaborating on the project; and (5) strengths and limitations of the REDCap system. REDCap is currently supporting 286 translational research projects in a growing collaborative network including 27 active partner institutions.
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            Development and validation of the State Hope Scale.

            Defining hope as a cognitive set comprising agency (belief in one's capacity to initiate and sustain actions) and pathways (belief in one's capacity to generate routes) to reach goals, the Hope Scale was developed and validated previously as a dispositional self-report measure of hope (Snyder et al., 1991). The present 4 studies were designed to develop and validate a measure of state hope. The 6-item State Hope Scale is internally consistent and reflects the theorized agency and pathways components. The relationships of the State Hope Scale to other measures demonstrate concurrent and discriminant validity; moreover, the scale is responsive to events in the lives of people as evidenced by data gathered through both correlational and causal designs. The State Hope Scale offers a brief, internally consistent, and valid self-report measure of ongoing goal-directed thinking that may be useful to researchers and applied professionals.
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              Community Health Worker Support for Disadvantaged Patients With Multiple Chronic Diseases: A Randomized Clinical Trial

              Objectives. To determine whether a community health worker (CHW) intervention improved outcomes in a low-income population with multiple chronic conditions. Methods. We conducted a single-blind, randomized clinical trial in Philadelphia, Pennsylvania (2013–2014). Participants (n = 302) were high-poverty neighborhood residents, uninsured or publicly insured, and diagnosed with 2 or more chronic diseases (diabetes, obesity, tobacco dependence, hypertension). All patients set a disease-management goal. Patients randomly assigned to CHWs also received 6 months of support tailored to their goals and preferences. Results. Support from CHWs (vs goal-setting alone) led to improvements in several chronic diseases (changes in glycosylated hemoglobin: −0.4 vs 0.0; body mass index: −0.3 vs −0.1; cigarettes per day: −5.5 vs −1.3; systolic blood pressure: −1.8 vs −11.2; overall P  = .08), self-rated mental health (12-item Short Form survey; 2.3 vs −0.2; P  = .008), and quality of care (Consumer Assessment of Healthcare Providers and Systems; 62.9% vs 38%; P  < .001), while reducing hospitalization at 1 year by 28% ( P  = .11). There were no differences in patient activation or self-rated physical health. Conclusions. A standardized CHW intervention improved chronic disease control, mental health, quality of care, and hospitalizations and could be a useful population health management tool for health care systems. Trial Registration. clinicaltrials.gov identifier: NCT01900470.
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                Author and article information

                Journal
                Prev Chronic Dis
                Prev Chronic Dis
                PCD
                Preventing Chronic Disease
                Centers for Disease Control and Prevention
                1545-1151
                2021
                05 August 2021
                : 18
                : E76
                Affiliations
                [1 ]Arizona Prevention Research Center at the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona
                [2 ]Mexican American Studies Department, College of Social and Behavioral Sciences, University of Arizona, Tucson, Arizona
                [3 ]Yuma County Health District, Yuma, Arizona
                [4 ]Arizona Community Health Workers Association, Yuma, Arizona
                [5 ]Mariposa Community Health Center, Nogales, Arizona
                Author notes
                Corresponding Author: Abby M. Lohr, MPH, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N Martin Ave, Tucson, AZ 85724. Telephone: 520-626-3203. Email: abbylohr@ 123456email.arizona.edu .
                Article
                21_0080
                10.5888/pcd18.210080
                8388205
                34351845
                1cef91f6-6097-4587-8224-2d0132e8bee8
                Copyright @ 2021

                Preventing Chronic Disease is a publication of the U.S. Government. This publication is in the public domain and is therefore without copyright. All text from this work may be reprinted freely. Use of these materials should be properly cited.

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                Categories
                Original Research
                Peer Reviewed

                Health & Social care
                Health & Social care

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