Document Type
Article
Publication Date
7-2024
Abstract
Introduction
The synergistic negative effects of type 2 diabetes (T2DM) and hypertension increases all-cause mortality and the medical complexity of management, which disproportionately impact Hispanics who face barriers to healthcare access. The Salud y Vida intervention was delivered to Hispanic adults living along the Texas-Mexico Border with comorbid poorly controlled T2DM and hypertension. The Salud y Vida multicomponent intervention incorporated community health workers (CHWs) into an expanded chronic care management model to deliver home-based follow-up visits and provided community-based diabetes self-management education.
Methods
We conducted multivariable longitudinal analysis to examine the longitudinal intervention effect on reducing systolic and diastolic blood pressure among 3806 participants enrolled between 2013 and 2019. Participants were compared according to their program participation as either higher (≥ 10 combined educational classes and CHW visits) or lower engagement (<10 >encounters). Data was collected between 2013 and 2020.
Results
Baseline mean systolic and diastolic blood pressure were 138 and 81 mmHg respectively. There were overall improvements in systolic (−6.49; 95% CI = [−7.13, −5.85]; p < 0.001) and diastolic blood pressure (−3.97; 95% CI = [−4.37, −3.56]; p < 0.001). The higher engagement group had greater systolic blood pressure reduction at 3 months (adjusted mean difference = −1.8 mmHg; 95% CI = [−3.2, −0.3]; p = 0.016) and at 15 month follow-up (adjusted mean difference = −2.3 mmHg; 95% CI = [−4.2, −0.39]; p = 0.0225) compared to the lower engagement group.
Conclusion
This intervention, tested and delivered in a real-world setting, provides an example of how CHW integration into an expanded chronic care model can improve blood pressure outcomes for individuals with co-morbidities.
Recommended Citation
Lopez, J. Z., Lee, M., Park, S. K., Zolezzi, M. E., Mitchell-Bennett, L. A., Yeh, P. G., ... & Reininger, B. M. (2024). An expanded chronic care management approach to multiple chronic conditions in Hispanics using community health workers as community extenders in the Rio Grande Valley of Texas. Preventive Medicine, 184, 107975. https://doi.org/10.1016/j.ypmed.2024.107975
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
Publication Title
Preventive Medicine
DOI
10.1016/j.ypmed.2024.107975
Comments
Under a Creative Commons license. http://creativecommons.org/licenses/by-nc/4.0/