Using community health workers to reduce disparities in diabetes care
The Foundation's initiative, Finding Answers: Disparities Research for Change, was designed to use research and evaluation to test hypothetical solutions for reducing racial and ethnic disparities in health care settings and actual disparity reduction outcomes in ongoing programs.This project will evaluate the effects of enhanced training of community health workers (CHWs) to reduce disparities in care in a low-income, racially and ethnically diverse population served by community health centers (CHCs). The Massachusetts Health Disparities Collaborative will evaluate phase two of its Diabetes Initiative with 10 CHCs. Phase one of the initiative has focused on training and supporting teams implementing rapid cycle system redesign for a cohort of 100 patients with diabetes in each of 17 CHCs. Latino and African American patients are over-represented in these cohorts at 30 and 15 percent, respectively. Phase two will test the effectiveness of using CHWs trained in the care model and patient education techniques in a pre-established, multisite collaborative that includes process and outcome evaluation. Matched pairs of CHCs will be randomized to an intervention of enhanced patient support by CHWs. CHWs will be trained in a diabetes curriculum integrated into the 45-hour curriculum of the Outreach Worker Training Institute of the Central Massachusetts Area Health Education Center. CHCs participating in the Collaborative have constructed a data collection infrastructure to assess changes in diabetes care among patients from diverse cultural and linguistic backgrounds. CHCs collect a wide range of data to assess the effects of quality improvement activities, including clinical quality indicators and patient assessments of care. In addition, qualitative data from each team's monthly narrative reports and site visits by the medical school evaluation team are used to document quality improvement activities, including barriers and facilitators to implementing changes in patient care. It is anticipated that CHWs will work with patients to improve self-management and to link patients to community resources that will assist in self-management-leading to improved outcomes and a reduction in disparities.
Amount Awarded $286,558.00
Awarded on: 11/27/2006
Time frame: 12/1/2006 - 3/31/2009
Grant Number: 59745