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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.