264706 Community Health Worker Effectiveness in Preventing and Managing Chronic Diseases Across Asian-American Ethnic Groups

Monday, October 29, 2012 : 3:15 PM - 3:30 PM

Ephraim Shapiro, PHD, MPA, MBA , Institute of Community Health and Research, New York University School of Medicine, New York, NY
Nadia Islam, PhD , Center for the Study of Asian American Health, NYU Institute of Community Health and Research, NYU School of Medicine, New York, NY
Rhodora Ursua, MPH , Center for the Study of Asian American Health, NYU School of Medicine, New York, NY
David E. Aguilar, MA , Center for the Study of Asian American Health, NYU Institute of Community Health and Research, NYU School of Medicine, New York, NY
Lindsey Riley, MPH , NYU School of Medicine, Center for the Study of Asian American Health, New York, NY
Jennifer Zanowiak, MA , Health Promotion and Prevention Research Center, New York University School of Medicine, New York, NY
Laura Wyatt, MPH , Center for the Study of Asian American Health, NYU School of Medicine, New York, NY
Chau Trinh-Shevrin, DrPH , Center for the Study of Asian American Health, NYU Institute of Community Health and Research, New York, NY
Mariano Rey, MD , Center for the Study of Asian American Health, Institute of Community Health and Research, NYU School of Medicine, New York, NY
Introduction: The negative effects of chronic diseases are rapidly increasing among Asian American populations. Longer residency in the U.S. is often associated with worsening health outcomes, especially for chronic diseases such as hypertension and diabetes. Community Health Workers (CHWs) are growing in use, with great potential to reduce health disparities associated with rising chronic disease incidence. There is a great paucity of studies, however, integrating CHW evaluations for multiple diseases and ethnic groups, especially looking beyond narrow clinical measures and/or subpopulations.

Objectives: This study sought to determine 1) Whether CHWs are effective in chronic disease programs for Asian Americans 2) How results vary across different Asian-American populations and diseases.

Methods/Results: This study integrated three randomized control trials involving collaborative evaluations between NYU School of Medicine and community groups using CBPR. The CHW programs being evaluated address diabetes and hypertension prevention and/or management for NYC Bangladeshis, Indians, Filipinos, and Koreans. Data was collected through in-person surveys of several hundred program and control group participants at baseline and follow-up. Measures were made consistent across intervention instruments. Outcome measures include levels of glucose, hypertension, obesity, physical activity, nutrition and access. Preliminary findings showed improvements in most but not all outcomes. Key variations in results by ethnicity and disease will be discussed.

Conclusion: Results show opportunities exist to improve immigrants' health and certain ethnic groups and chronic diseases may especially benefit from innovative CHW use. Cross-national comparisons across diseases provide a more complex understanding of CHW effectiveness and allow better targeting of interventions.

Learning Areas:
Chronic disease management and prevention
Diversity and culture
Epidemiology
Implementation of health education strategies, interventions and programs
Public health or related research

Learning Objectives:
1) Identify challenges in evaluating the complex roles of Community health Workers (CHWs)for immigrants 2) Understand CHW effectiveness in chronic disease programs for Asian American immigrants 3) Describe variations in CHW effectiveness for clinical and behavioral outcomes across different ethnic groups and diseases

Keywords: Asian Americans, Chronic Diseases

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have extensive training and experience in research and evaluation of chronic disease programs for immigrants especially those using community health workers.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.