Community Health Workers as Trust Builders and Healers: A Cohort Study in Primary Care

Robert L. Ferrer; Carolina Gonzalez Schlenker; Inez Cruz; Polly Hitchcock Noël; Raymond F. Palmer; Ramin Poursani; Carlos Roberto Jaén

doi:10.1370/afm.2848

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RE: Community Health Workers as Trust Builders and Healers: A Cohort Study in Primary Care
Elizabeth M Devery

Published on: 27 February 2023
RE: Community Health Workers as Trust Builders and Healers: A Cohort Study in Primary Care
Shalina Nair

Published on: 24 January 2023

Published on: (27 February 2023)
Page navigation anchor for RE: Community Health Workers as Trust Builders and Healers: A Cohort Study in Primary Care
RE: Community Health Workers as Trust Builders and Healers: A Cohort Study in Primary Care
Elizabeth M Devery, undergraduate, The Ohio State University
As aspiring healthcare professionals with strong holistic interest in primary care delivery, we hold great curiosity in learning more about your 4-year, community health worker (CHW) intervention program for patients with uncontrolled type 2-diabetes mellitus (T2DM) and accompanying psychological risk factors. As demonstrated in your study, CHWs hold great promise in helping patients with chronic diseases improve their health and quality of life. Through careful review of methods employed, and outcomes described, multiple questions crossed our minds. As this study was conducted from 2013 to 2017, we are curious if and how the CHW intervention transitioned to a permanent program? Overall improvement of care, continuity, and quality of life for those with chronic illnesses are often rooted in issues surrounding social impoverishment as a systemic cause. This led us to ponder, if this type of care were to be implemented in other areas facing prevalent instances of social injustice and scarcity outside of San Antonio, Texas, do you believe that the outcomes would be similar? Thank you for considering our questions.

Competing Interests: None declared.
Published on: (24 January 2023)
Page navigation anchor for RE: Community Health Workers as Trust Builders and Healers: A Cohort Study in Primary Care
RE: Community Health Workers as Trust Builders and Healers: A Cohort Study in Primary Care
Shalina Nair, Family Physician, The Ohio State University
I want to thank the authors for conducting this important study demonstrating the benefit of community health workers as part of care teams to reduce health disparities. This is meaningful in showing how this expanded care team along with patient engagement in self-care strategies can improve health outcomes. The intervention was well implemented and conducted over several years, an amount of time necessary to realize the long-term benefit. It was useful that the authors included the patient perspective with individualized goals which helped with engagement in developing skills to improve their health journey and outcomes. This was essential for success.

This study appears well defined and measured, notably for what success looks like if achieved. The behavioral changes seem to lend themselves towards sustainability therefore population health impact with improved diabetes control and reduced risks for hospital visits. My impression is that the results are positive and worth exploring further for sustainability and expansion, resource permitting. I am interested in the authors thoughts as to the demographic breakdown between groups, notably proportion of English preferred in the self-care group compared to the other groups and if this may have potentially contributed to their motivation.

Investment into care teams including CHW’s is crucial in the primary care environment if we are going to impact change and reduce barriers to care. Measuring variables such...
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I want to thank the authors for conducting this important study demonstrating the benefit of community health workers as part of care teams to reduce health disparities. This is meaningful in showing how this expanded care team along with patient engagement in self-care strategies can improve health outcomes. The intervention was well implemented and conducted over several years, an amount of time necessary to realize the long-term benefit. It was useful that the authors included the patient perspective with individualized goals which helped with engagement in developing skills to improve their health journey and outcomes. This was essential for success.

This study appears well defined and measured, notably for what success looks like if achieved. The behavioral changes seem to lend themselves towards sustainability therefore population health impact with improved diabetes control and reduced risks for hospital visits. My impression is that the results are positive and worth exploring further for sustainability and expansion, resource permitting. I am interested in the authors thoughts as to the demographic breakdown between groups, notably proportion of English preferred in the self-care group compared to the other groups and if this may have potentially contributed to their motivation.

Investment into care teams including CHW’s is crucial in the primary care environment if we are going to impact change and reduce barriers to care. Measuring variables such as improved health equity, reduced disparities, and improved health outcomes for diabetes or other chronic diseases as well as cost are important for the overall picture regarding support to invest into such resources. I appreciate this group invested both time and resources into this intervention and improved the lives of their community. This type of work is important in our field to demonstrate the significance of care team members and their impact on improving health equity and outcomes.
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Competing Interests: None declared.