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患者对由社区卫生工作者主导的干预措施的可接受性和有效性的看法,该干预旨在提高服务不足的拉丁裔成年人的慢性肾脏病知识并促进筛查:CARE 2.0研究

Patients' Perspectives on the Acceptability and Effectiveness of a Community Health Worker-Led Intervention to Increase Chronic Kidney Disease Knowledge and Screening among Underserved Latine Adults: The CARE 2.0 Study.

作者信息

Diaz-Martinez Janet, Delgado-Enciso Ivan, Duran Carlos, Kallus Laura, Jean-Pierre Aydeivis, Lopez Brenda, Mancilla Jessica, Madruga Yoel, Hernandez-Fuentes Gustavo A, Kotzker Wayne, Delgado-Enciso Osiris, Wagner Eric, Hospital Michelle

机构信息

Research Center in a Minority Institution, Florida International University (FIU-RCMI), Miami, FL 33199, USA.

Robert Stempel College of Public Health and School of Social Work, Florida International University, Miami, FL 33199, USA.

出版信息

Behav Sci (Basel). 2024 Aug 27;14(9):750. doi: 10.3390/bs14090750.

Abstract

In the United States, Chronic Kidney Disease (CKD) affects approximately 1 in 7 adults. Despite its significant impact, CKD awareness, education, and screening are often lacking among underserved Latine populations, leading to poorer health outcomes and higher mortality rates. Various studies highlight the crucial role of Community Health Workers (CHWs) in improving health outcomes within minority communities both domestically and globally. However, there remains a gap in research on the acceptance and effectiveness of CHW-led interventions targeting CKD. This prospective intervention study employed a pre-post quasi-experimental design to evaluate a CHW-led educational program aimed at enhancing CKD knowledge, screening, and monitoring among Latines with low health literacy and English proficiency. CHWs utilized a culturally tailored CKD Flipchart, and 100 underserved patients received the intervention. Feedback from 85 participants who completed post-intervention surveys indicated high satisfaction with the program's relevance and the professionalism of the CHWs. Importantly, 85% expressed a positive intention to seek kidney care following the intervention. Preliminary analysis of medical records before and after the intervention showed improvements in glycemic control (median change = -18.0, = 0.014) and triglyceride levels (median change = -29.0, = 0.035), suggesting the program's effectiveness in managing CKD risk factors. These findings highlight the potential of CHW-led interventions to reduce kidney health disparities among underserved communities.

摘要

在美国,慢性肾脏病(CKD)影响着约七分之一的成年人。尽管其影响重大,但在服务不足的拉丁裔人群中,对CKD的认知、教育和筛查往往不足,导致健康结果较差和死亡率较高。多项研究强调了社区卫生工作者(CHW)在改善国内和全球少数族裔社区健康结果方面的关键作用。然而,针对以CHW为主导的CKD干预措施的接受度和有效性的研究仍存在空白。这项前瞻性干预研究采用前后准实验设计,以评估一项由CHW主导的教育项目,该项目旨在提高健康素养和英语水平较低的拉丁裔人群对CKD的认识、筛查和监测。CHW使用了一份根据文化定制的CKD活动挂图,100名服务不足的患者接受了干预。85名完成干预后调查的参与者的反馈表明,他们对该项目的相关性和CHW的专业性高度满意。重要的是,85%的人表示在干预后有寻求肾脏护理的积极意愿。对干预前后病历的初步分析显示,血糖控制(中位数变化=-18.0,P=0.014)和甘油三酯水平(中位数变化=-29.0,P=0.035)有所改善,表明该项目在管理CKD风险因素方面有效。这些发现凸显了以CHW为主导的干预措施在减少服务不足社区肾脏健康差距方面的潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e594/11429309/985fe33893c8/behavsci-14-00750-g001.jpg

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