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Author: Publisher: ISBN: Category : Languages : en Pages : 18
Book Description
We conducted a systematic review on outcomes and costs of community health worker (CHW) interventions. CHWs are increasingly expected to improve health outcomes cost-effectively for the underserved. We searched Medline, Cochrane Collaboration resources, and the Cumulative Index to Nursing and Allied Health Literature for studies conducted in the United States and published in English from 1980 through November 2008. We dually reviewed abstracts, full-text articles, data abstractions, quality ratings, and strength of evidence grades and resolved disagreements by consensus. We included 53 studies on outcomes of CHW interventions and 6 on cost or cost-effectiveness. For outcomes, limited evidence (5 studies) suggests that CHW interventions can improve participant knowledge compared with alternative approaches or no intervention. We found mixed evidence for participant behavior change (22 studies) and health outcomes (27 studies). Some studies suggested that CHW interventions can result in greater improvements in participant behavior and health outcomes compared with various alternatives, but other studies suggested that CHW interventions provide no statistically different benefits than alternatives. We found low or moderate strength of evidence suggesting that CHWs can increase appropriate health care utilization for some interventions (30 studies). Six studies with economic information yielded insufficient data to evaluate the cost-effectiveness of CHW interventions relative to other interventions. CHWs can improve outcomes for underserved populations for some health conditions. The effectiveness of CHWs in many health care areas requires further research that addresses the methodologic limitations of prior studies and that contributes to translating research into practice.
Author: Publisher: ISBN: Category : Languages : en Pages : 18
Book Description
We conducted a systematic review on outcomes and costs of community health worker (CHW) interventions. CHWs are increasingly expected to improve health outcomes cost-effectively for the underserved. We searched Medline, Cochrane Collaboration resources, and the Cumulative Index to Nursing and Allied Health Literature for studies conducted in the United States and published in English from 1980 through November 2008. We dually reviewed abstracts, full-text articles, data abstractions, quality ratings, and strength of evidence grades and resolved disagreements by consensus. We included 53 studies on outcomes of CHW interventions and 6 on cost or cost-effectiveness. For outcomes, limited evidence (5 studies) suggests that CHW interventions can improve participant knowledge compared with alternative approaches or no intervention. We found mixed evidence for participant behavior change (22 studies) and health outcomes (27 studies). Some studies suggested that CHW interventions can result in greater improvements in participant behavior and health outcomes compared with various alternatives, but other studies suggested that CHW interventions provide no statistically different benefits than alternatives. We found low or moderate strength of evidence suggesting that CHWs can increase appropriate health care utilization for some interventions (30 studies). Six studies with economic information yielded insufficient data to evaluate the cost-effectiveness of CHW interventions relative to other interventions. CHWs can improve outcomes for underserved populations for some health conditions. The effectiveness of CHWs in many health care areas requires further research that addresses the methodologic limitations of prior studies and that contributes to translating research into practice.
Author: Julie Ann St. John Publisher: Springer Nature ISBN: 3030563758 Category : Medical Languages : en Pages : 428
Book Description
Community health workers (CHWs) are an increasingly important member of the healthcare and public health professions who help build primary care capacity. Yet, in spite of the exponential growth of CHW interventions, CHW training programs, and CHW certification and credentialing by state agencies, a gap persists in the literature regarding current CHW roles and skills, scope of practice, CHW job settings, and national standards. This collection of contributions addresses this gap by providing information, in a single volume, about CHWs, the roles CHWs play as change agents in their communities, integration of CHWs into healthcare teams, and support and recognition of the CHW profession. The book supports the CHW definition as defined by the American Public Health Association (APHA), Community Health Worker Section (2013), which states, “A community health worker is a frontline public health worker who is a trusted member of and/or has an unusually close understanding of the community served.” The scope of the text follows the framework of the nationally recognized roles of CHWs that came out of a national consensus-building project called “The Community Health Worker (CHW) Core Consensus (C3) Project”. Topics explored among the chapters include: Cultural Mediation Among Individuals, Communities, and Health and Social Service Systems Care Coordination, Case Management, and System Navigation Advocating for Individuals and Communities Building Individual and Community Capacity Implementing Individual and Community Assessments Participating in Evaluation and Research Uniting the Workforce: Building Capacity for a National Association of Community Health Workers Promoting the Health of the Community is a must-have resource for CHWs, those interested in CHW scope of practice and/or certification/credentialing, anyone interested in becoming a CHW, policy-makers, CHW payer systems, CHW supervisors, CHW employers, CHW instructors/trainers, CHW advocates/supporters, and communities served by CHWs.
Author: U. S. Department of Health and Human Services Publisher: Createspace Independent Pub ISBN: 9781490324487 Category : Medical Languages : en Pages : 400
Book Description
The United States has experienced remarkable improvements in public health and medical progress throughout much of the twentieth century, including major advances in pharmaceutical and medical device innovation and gains in life expectancy. These improvements, however, have not been accessible to all parts of U.S. society. Substantial disparities in life expectancy, health, and health care persist. Although many actors—including health care systems, insurers, health care providers, and patients—contribute to these disparities, bias, discrimination, and stereotyping during the clinical encounter also explain health care disparities. Experts recommend reducing fragmentation in health care systems, improving awareness on the part of health care providers of these problems, strengthening culturally competent approaches to the delivery of health care, and increasing the diversity of the health care workforce, as strategies to reduce health care disparities. A core component in recommendations to address healthcare disparities is the involvement of the community: specifically, the involvement of community health workers (CHWs). The RTI International–University of North Carolina at Chapel Hill Evidence-based Practice Center (RTI-UNC EPC) conducted a systematic review on outcomes of CHW interventions. The review addressed four key questions (KQs): KQ 1. How do CHWs interact with participants? Specifically, what is the place of service, type of service, type of educational materials used, duration of interaction with participants, and length of followup? KQ 2. What is the impact of CHWs on outcomes, particularly knowledge, behavior, satisfaction, health outcomes, and health care utilization? KQ 3. What is known about the cost-effectiveness of CHWs for improving health outcomes? KQ 4a. What are characteristics of training for CHWs in the outpatient setting? KQ 4b. Are particular training characteristics associated with improved outcomes for patients?
Author: Cecilia Hodges Publisher: Nova Science Publishers ISBN: 9781634850605 Category : Community health aides Languages : en Pages : 0
Book Description
Book & CD-ROM. A community health worker (CHW) is a frontline public health worker who, as a member of the community, has the potential to deliver cost-effective, high quality, and culturally competent health services within team-based care models. This book reviews select health services research findings on community health worker utilisation that are relevant to U.S. policymakers and considers the key challenges to fully realiaing the potential for CHWs to improve health care delivery. This book is accompanied by a CD-ROM which includes appendices A through E for Chapter Two, Outcomes of Community Health Worker Interventions.
Author: Tim Berthold Publisher: John Wiley & Sons ISBN: 0470496797 Category : Medical Languages : en Pages : 594
Book Description
Foundations for Community Health Workers Foundations for Community Health Workers is a training resource for client- and community-centered public health practitioners, with an emphasis on promoting health equality. Based on City College of San Francisco's CHW Certificate Program, it begins with an overview of the historic and political context informing the practice of community health workers. The second section of the book addresses core competencies for working with individual clients, such as behavior change counseling and case management, and practitioner development topics such as ethics, stress management, and conflict resolution. The book's final section covers skills for practice at the group and community levels, such as conducting health outreach and facilitating community organizing and advocacy. Praise for Foundations for Community Health Workers "This book is the first of its kind: a manual of core competencies and curricula for training community health workers. Covering topics from health inequalities to patient-centered counseling, this book is a tremendous resource for both scholars of and practitioners in the field of community-based medicine. It also marks a great step forward in any setting, rich or poor, in which it is imperative to reduce health disparities and promote genuine health and well-being." Paul E. Farmer, MD., PhD, Maude and Lillian Presley Professor of Social Medicine in the Department of Global Health and Social Medicine at Harvard Medical School; founding director, Partners In Health. "This book is based on the contributions of experienced CHWs and advocates of the field. I am confident that it will serve as an inspiration for many CHW training programs." Yvonne Lacey, CHW, former coordinator, Black Infant Health Program, City of Berkeley Health Department; former chair, CHW Special Interest Group for the APHA. "This book masterfully integrates the knowledge, skills, and abilities required of a CHW through storytelling and real life case examples. This simple and elegant approach brings to life the intricacies of the work and espouses the spirit of the role that is so critical to eliminating disparities a true model educational approach to emulate." Gayle Tang, MSN, RN., director, National Linguistic and Cultural Programs, National Diversity, Kaiser Permanente "Finally, we have a competency-based textbook for community health worker education well informed by seasoned CHWs themselves as well as expert contributors." Donald E. Proulx, CHW National Education Collaborative, University of Arizona
Author: National Research Council Publisher: National Academies Press ISBN: 030918651X Category : Medical Languages : en Pages : 163
Book Description
Randomized clinical trials are the primary tool for evaluating new medical interventions. Randomization provides for a fair comparison between treatment and control groups, balancing out, on average, distributions of known and unknown factors among the participants. Unfortunately, these studies often lack a substantial percentage of data. This missing data reduces the benefit provided by the randomization and introduces potential biases in the comparison of the treatment groups. Missing data can arise for a variety of reasons, including the inability or unwillingness of participants to meet appointments for evaluation. And in some studies, some or all of data collection ceases when participants discontinue study treatment. Existing guidelines for the design and conduct of clinical trials, and the analysis of the resulting data, provide only limited advice on how to handle missing data. Thus, approaches to the analysis of data with an appreciable amount of missing values tend to be ad hoc and variable. The Prevention and Treatment of Missing Data in Clinical Trials concludes that a more principled approach to design and analysis in the presence of missing data is both needed and possible. Such an approach needs to focus on two critical elements: (1) careful design and conduct to limit the amount and impact of missing data and (2) analysis that makes full use of information on all randomized participants and is based on careful attention to the assumptions about the nature of the missing data underlying estimates of treatment effects. In addition to the highest priority recommendations, the book offers more detailed recommendations on the conduct of clinical trials and techniques for analysis of trial data.
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Author: Julie Ann St. John
Author: U. S. Department of Health and Human Services
Author: Cecilia Hodges
Author: John E. Ware, Jr.
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Author: Tim Berthold
Author: National Research Council
Author: United States. Agency for Healthcare Research and Quality