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Effectiveness of a Community Health Worker Cardiovascular Risk Reduction Program in Public Health and Health Care Settings.
MedLine Citation:
PMID:  23153152     Owner:  NLM     Status:  Publisher    
Objectives. We evaluated whether a program to prevent coronary heart disease (CHD) with community health workers (CHWs) would improve CHD risk in public health and health care settings. Methods. The CHWs provided point-of-service screening, education, and care coordination to residents in 34 primarily rural Colorado counties. The CHWs utilized motivational interviewing and navigated those at risk for CHD into medical care and lifestyle resources. A software application generated a real-time 10-year Framingham Risk Score (FRS) and guideline-based health recommendations while supporting longitudinal caseload tracking. We used multiple linear regression analysis to determine factors associated with changes in FRS. Results. From 2010 to 2011, among 4743 participants at risk for CHD, 53.5% received medical or lifestyle referrals and 698 were retested 3 or more months after screening. We observed statistically significant improvements in diet, weight, blood pressure, lipids, and FRS with the greatest effects among those with uncontrolled risk factors. Successful phone interaction by the CHW led to lower FRS at retests (P = .04). Conclusions. A CHW-based program within public health and health care settings improved CHD risk. Further exploration of factors related to improved outcomes is needed. (Am J Public Health. Published online ahead of print November 15, 2012: e1-e9. doi:10.2105/AJPH.2012.301068).
Mori J Krantz; Stephanie M Coronel; Elizabeth M Whitley; Rita Dale; Jason Yost; Raymond O Estacio
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-15
Journal Detail:
Title:  American journal of public health     Volume:  -     ISSN:  1541-0048     ISO Abbreviation:  Am J Public Health     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1254074     Medline TA:  Am J Public Health     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Mori J. Krantz, Stephanie M. Coronel, Rita Dale, and Raymond O. Estacio are with the Community Health Department, The Colorado Prevention Center, Aurora. Elizabeth M. Whitley and Raymond O. Estacio are with Community Health Services, Denver Health and Hospital Authority, Denver, CO. Mori J. Krantz, Jason Yost, and Raymond O. Estacio are with the Department of Medicine, University of Colorado Health Sciences Center, Aurora. Mori J. Krantz is also with Department of Medicine, Division of Cardiology, Denver Health and Hospital Authority, Denver, CO.
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