Physician-community health worker partnering to support XXXX self-management in primary care.

@entity1 @entity4051 @entity6 @entity497 @entity164 @entity165
BACKGROUND: The role of @entity497 ( @entity497 ) has expanded from outreach and education to working within a clinical team in a primary care setting. AIM: To improve self-management among @entity1 with @entity164 2 @entity6 incorporating @entity497 as members of a clinical team. METHODS: A cohort of 114 @entity1 with @entity164 2 @entity6 enrolled in 2007 participated in a teambased self-management intervention with followup in 2008. The study assessed whether significant changes occurred in clinical, @entity1 satisfaction and activation measures after the intervention compared with baseline. The programme was located at St Luke's Health Care Center in San Francisco, California, in an ethnically diverse neighbourhood serving predominantly low-income Latino @entity1 . Clinical outcomes measured included glycosylated haemoglobin (HbA1c), low-density lipoprotein (LDL), blood pressure and total @entity165 . A @entity1 Activation Measure (PAM) assessed self-management. Both provider and @entity1 experiences with the programme were also assessed using a @entity1 telephone satisfaction survey and provider focus group. RESULTS: The majority of @entity1 were Latino Spanish speaking @entity1 on public insurance. Thirty-one @entity1 participated in a telephone satisfaction survey. Six providers participated in a focus group to assess satisfaction with care. HealthFirst had a positive impact, improving @entity4051 c among high-risk @entity1 with @entity164 2 @entity6 (HbA1c>=  9.0) and maintaining glycaemic control among @entity1 with controlled glycaemic level at baseline ( @entity4051 c<7.0). In addition, LDL, total @entity165 and self-management outcomes significantly improved. Ninety-seven percent of @entity1 were satisfied with the @entity497 ' support. Overall, providers' comfort level in referring @entity1 to @entity497 was very high. CONCLUSIONS: Physician-CHW partnership had a positive impact on @entity1 ' self-management skills and clinical outcomes. @entity1 and physicians also had higher satisfaction with overall care. With appropriate training, @entity497 can collaborate as team members with primary care providers and with non-medical providers to improve the quality of care.
