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A look at the process and steps used to design two targeted community health worker interventions by emphasizing a community-based, multidisciplinary approach.
In recent years, improving health outcomes and reducing healthcare expenditures for Medicare and Medicaid beneficiaries has become increasingly imperative. Several initiatives in the Affordable Care Act (ACA) provide incentives to hospitals and medical providers to achieve the triple aim of improving the patient care experience, improving population health, and reducing the per capita cost of healthcare.
But traditional methods of improving care may not be effective when addressing populations suffering from health disparities, such as African Americans, who suffer disproportionately from many chronic disease factors. The Jackson Heart Study (JHS), a longitudinal observational study analyzing the health outcomes of 5,301 African Americans, has identified some contributing factors to health disparities in this research cohort (see article on page 46). One finding from this study is that treatment nonadherence in study participants contributed to poor health outcomes (Addison et al., 2011). The research suggests that public health interventions aimed at helping to increase treatment adherence and the awareness of adverse outcomes related to treatment non-adherence could have a positive impact on vulnerable populations at risk for non-adherence.
The Centers for Disease Control and Prevention (CDC) reviewed community health worker interventions and has found that such interventions have been shown to improve health outcomes of vulnerable populations. Based on these findings, we developed two intervention models to assess their relative impact on health outcomes and use for a convenience sample of African Americans in Mississippi who are not part of the JHS cohort. The intervention tests two training levels of community health workers (Addison et al., 2011), including the Advanced Community Health Worker model developed by the Global Community Health Worker Training Program at Jackson State University, and the Central Mississippi Area Health Education Center. The Center functions under the Owens Health and Wellness Center at Tougaloo College. The Tougaloo College Area Health Education Center Community Health Worker training program operates as part of the Central Mississippi Area Health Education Center.
Jackson State University received funding from the Centers for Medicare & Medicaid Services (CMS) to deploy well-trained community health workers to staff Community Health Houses throughout the Mississippi Delta region. Both interventions are...