Using Community Health Workers to Improve Health Care in Marginalized Communities

For those who are members of a marginalized population, community health workers can serve a vital purpose.

Community health workers have been found to help improve the nonmedical aspects of life that influence a person’s health, such as improving patient knowledge regarding diseases, affecting behavioral change, and reducing healthcare system costs. Researchers have created a standardized program to better measure the effect of community health workers called the IMPaCT (Individualized Management for Patient-Centered Targets) intervention, which concluded with mixed results.¹

A commentary published in JAMA Internal Medicine² discussed the original study, noting that that the investigators’ results were conflicting, indicating that studying the effect of social determinants of health is inherently challenging. The issues that patients face can be very complex, with coexisting medical and nonmedical needs that are not easily understood and measured through outcomes. In addition, the research used self-ratings from patients, which can be influenced by factors outside the intervention. The great diversity of patients across the 3 study locations may have influenced the results of the research as well.

The investigators citing the IMPaCT study offer anecdotal evidence for the positive effects of community health workers on patients. They say that engaging community health workers can lead patients to become more involved in their own healthcare. In addition, patients and community health workers often build a lasting relationship of support that continues beyond the initial timeline of 6 or 12 months. The investigators added that the researchers who created the standardized IMPaCT measurement for the effect of community health workers should collect more data pertaining to each studied location to better understand the specific variables involved. They also pointed out that because community health workers may have long-term effects on patients’ health, follow-up over a longer period may yield more information about delayed results of community health workers intervention.

References

1.  Kangovi S, Mitra N, Norton L, et al. Effect of community health worker support on clinical outcomes of low-income patients across primary care facilities. JAMA Intern Med. 2018;178(12):1635-1643.
2. Graddy R, Fingerhood M. How community health workers can affect health care. JAMA Intern Med. 2018;178(12):1643-1644.

This article originally appeared on Medical Bag