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

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.