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社区 Rx:可扩展、低强度社区资源转介干预的真实世界对照临床试验。

CommunityRx: A Real-World Controlled Clinical Trial of a Scalable, Low-Intensity Community Resource Referral Intervention.

机构信息

Stacy Tessler Lindau is with the Departments of Obstetrics and Gynecology and Medicine-Geriatrics and Palliative Medicine, The University of Chicago, Chicago, IL. Jennifer A. Makelarski, Emily M. Abramsohn, and Kelly Boyd are with the Department of Obstetrics and Gynecology, The University of Chicago. David G. Beiser is with the Department of Medicine, Section of Emergency Medicine, The University of Chicago. Chiahung Chou is with the Department of Health Outcomes Research and Policy, Auburn University, Auburn, AL. Mihai Giurcanu, Chuanhong Liao, and L. Philip Schumm are with the Department of Public Health Sciences, The University of Chicago. Elbert S. Huang and Elizabeth L. Tung are with the Department of Medicine, Section of General Internal Medicine, The University of Chicago.

出版信息

Am J Public Health. 2019 Apr;109(4):600-606. doi: 10.2105/AJPH.2018.304905. Epub 2019 Feb 21.

Abstract

OBJECTIVES

To test the effect of CommunityRx, a scalable, low-intensity intervention that matches patients to community resources, on mental health-related quality of life (HRQOL) (primary outcome), physical HRQOL, and confidence in finding resources.

METHODS

A real-world trial assigned publicly insured residents of Chicago, Illinois, aged 45 to 74 years to an intervention (n = 209) or control (n = 202) group by alternating calendar week, December 2015 to August 2016. Intervention group participants received usual care and an electronic medical record-generated, personalized list of community resources. Surveys (baseline, 1-week, 1- and 3-months) measured HRQOL and confidence in finding community resources to manage health.

RESULTS

At 3 months, there was no difference between groups in mental (-1.03; 95% confidence interval [CI] = -3.02, 0.96) or physical HRQOL (0.59; 95% CI = -0.98, 2.16). Confidence in finding resources was higher in the intervention group (odds ratio = 2.08; 95% CI = 1.18, 3.63); the effect increased at each successive time point. Among intervention group participants, 65% recalled receiving the intervention; 48% shared community resource information with others.

CONCLUSIONS

CommunityRx did not increase HRQOL, but its positive effect on confidence in finding resources for self-care suggests that this low-intensity intervention may have a role in population health promotion.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT02435511.

摘要

目的

测试 CommunityRx 的效果,这是一种可扩展的、低强度的干预措施,可将患者与社区资源相匹配,以改善心理健康相关生活质量(主要结果)、身体心理健康相关生活质量以及寻找资源的信心。

方法

一项真实世界试验通过交替日历周的方式,将伊利诺伊州芝加哥市的 45 至 74 岁的公共保险参保者分配到干预组(n=209)或对照组(n=202)。干预组参与者接受常规护理和电子病历生成的个性化社区资源清单。调查(基线、1 周、1 个月和 3 个月)测量心理健康相关生活质量和寻找社区资源管理健康的信心。

结果

在 3 个月时,两组之间的心理健康(-1.03;95%置信区间 [CI] = -3.02,0.96)或身体心理健康相关生活质量(0.59;95% CI = -0.98,2.16)均无差异。干预组寻找资源的信心更高(优势比=2.08;95% CI = 1.18,3.63);这种效果在每个连续的时间点都有所增加。在干预组参与者中,65%的人回忆说收到了干预措施;48%的人将社区资源信息与他人分享。

结论

CommunityRx 并未提高心理健康相关生活质量,但它对自我保健寻找资源的信心有积极影响,这表明这种低强度干预措施可能在人群健康促进方面发挥作用。

试验注册

ClinicalTrials.gov 标识符:NCT02435511。

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