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American Public Health Association
133rd Annual Meeting & Exposition
December 10-14, 2005
Philadelphia, PA
APHA 2005
 
5038.0: Wednesday, December 14, 2005 - 8:50 AM

Abstract #112203

Community Health Worker Roles in the Management of Diabetes and Emotional Health

Carol A. Brownson, MSPH1, Mary O'Toole, PhD2, Gowri Shetty, MPH, MS2, Edwin B. Fisher, PhD3, Sally Hurst, BA4, Lourdes Rangel5, Floribella Redondo6, Carlos Flores7, Dawn Heffernan, RN, MS8, Alison Jones Webb9, Angela J. Camilleri, MPH, MA10, and Kenneth S. Babamoto, PharmD, MPH10. (1) Robert Wood Johnson Foundation Diabetes Initiative, National Program Office, Washington University School of Medicine, 4444 Forest Park Avenue, Suite 6700, St. Louis, MO 63108-2212, 314-286-1915, cbrownso@im.wustl.edu, (2) Division of Health Behavior Research, Washington University School of Medicine, 4444 Forest Park Avenue, Suite 6700, St. Louis, MO 63108-2212, (3) Department of Health Behavior and Health Education, University of North Carolina at Chapel Hill, School of Public Health, Rosenau Hall, CB #7440, Chapel Hill, NC 63108-2212, (4) Department of Family and Community Health, Mashall University School of Medicine, Rt. 1, Box 615-A, Scarbro, WV 25917, (5) Gateway Community Health Center, 2309 Saunders, Laredo, TX 78044, (6) Campesinos Sin Fronteras, 611 W. Main Street, PO Box 423, Somerton, AZ 85350, (7) Preventive Medicine Department, La Clinica de La Raza Fruitvale, 1515 Fruitvale Ave, Oakland, CA 94601, (8) Holyoke Health Center, Inc, 230 Maple Street, P.O. Box 6260, Holyoke, MA 01041, (9) Community Health Improvement, MaineGeneral Medical Center, 149 North Street, Waterville, ME 04901, (10) Community Health, Pfizer Health Solutions, 2400 Broadway, Suite 500, Santa Monica, CA 90404

Emotional distress, including depression, is more prevalent among those with diabetes than in the general population. Along with depression, negative emotional health is also a risk factor for diabetes and is associated with complications in diabetes. Community Health Workers (CHWs) have been shown to be effective in increasing access to care and helping people manage a variety of health conditions. In The Robert Wood Johnson Foundation Diabetes Initiative, four grantees are using CHWs as an integral part of their key intervention strategies to address depression and emotional health among people with diabetes. Pfizer Health Solutions' Amigos en Salud diabetes/comorbid depression research program is implemented at one site. In three of the four sites, the CHW is part of the clinical service delivery system, although the models vary greatly by site. Some of their roles include screening the patients for depression using the PHQ9; referring patients to the primary care physicians or mental health services as needed; providing self-management education for patients with depression or other emotional health needs; and providing ongoing support for these patients on a regular basis either through weekly phone calls, classes or support groups. At the fourth site the CHWs work through a community based organization, facilitating support groups and providing education to individuals and families, and acting as a bridge to providers. This session will demonstrate the use of CHWs as a successful strategy to address emotional health using four different models. Preliminary data from these sites will be shared.

Learning Objectives:

Keywords: Diabetes, Depression

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

CHWs as Integral Members of the Healthcare Team

The 133rd Annual Meeting & Exposition (December 10-14, 2005) of APHA