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Enhancing the role of home health aides as congestive heart failure and diabetes disease management coaches using community based participatory research and community health worker training techniques

Catherine Kelleher, ScD, MPH, MS, RN1, Sheila Curry, MS2, Miyong T. Kim, PhD, RN3, Nadine Kidd, MS, RN4, Joan S. Obecny, MS, ANP, RN4, Shirley Devitt, MS, RN4, Margaret A. Terry, MS, RN4, Penny Carlo, MS, RN4, Veronica S. Longstreth, MS, RN4, Shannon Nagy, BS, RN1, Katie Huffling, BS, RN1, Donald O. Fedder, DrPH2, Lee Bone, MPH, RN5, Frances Wacker, MSW4, and Ana Sanchez, MHS1. (1) Department of Organizational Systems and Adult Health, University of Maryland School of Nursing, 655 West Lombard Street, Room 475C, Baltimore, MD 21201, 410-706-3187, kelleher@son.umaryland.edu, (2) Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, 515 West Lombard Street, Baltimore, MD 21201, (3) Johns Hopkins University School of Nursing, 525 North Wolfe Street, Baltimore, MD 21205, (4) MedStar Health VNA, 4061 Powder Mill Road, Suite 210, Calverton, MD 20705, (5) Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, 624 North Broadway, Hampton House, Room 608, Baltimore, MD 21205

Traditionally, home health aides (HHAs) assist patients with activities of daily living. Using principles of community-based participatory research (CBPR), and our extensive experience with training and performance evaluation of HHAs and community health workers (CHWs), a 4-year, AHRQ-funded, randomized intervention trial, currently underway, is testing the impact of training HHAs to function in enhanced roles as congestive heart failure (CHF) and diabetes disease management coaches (DMCs) in partnership with RNs. Study partners include MedStar Health VNA, and faculty and staff from the University of Maryland Schools of Nursing, Pharmacy and Medicine, and the Johns Hopkins University Bloomberg School of Public Health and School of Nursing. HHAs are being randomly selected for 120 hours of initial intensive training, 32 hours of transitional training, followed by weekly debriefings and educational reinforcement. Over 1700 patients are being randomly assigned to a traditional HHA, an HHA DMC, or to no HHA. This presentation will focus on building the partnership; planning, implementing, and evaluating the training, including acceptability and impact of the HHA-DMC; and integrating the coaching role with the usual HHA role. Outcome measures include HHA-DMC job satisfaction and retention, patient satisfaction, and reductions in home health care costs, re-hospitalization, and ER use. Implications for CBPR and the HHA DMC role will be discussed.

Learning Objectives:

Keywords: Community-Based Partnership, Community Health Advisor

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

From Rural to Urban: Community Health Workers Promoting Healthy Communities

The 132nd Annual Meeting (November 6-10, 2004) of APHA