Protocol for LINKS (linking individual needs to community and clinical services): a prospective matched observational study of a community health worker community clinical linkage intervention on the US-Mexico border
Protocol for LINKS (linking individual needs to community and clinical services): a prospective matched observational study of a community health worker community clinical linkage intervention on the US-Mexico border
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DOI：
10.1186/s12889-019-6725-1
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发表时间：
2019-04-11
影响因子：
4.5
通讯作者：
Bell, Melanie L.
中科院分区：
文献类型：
--
作者：
Lohr, Abby M.;Ingram, Maia;Bell, Melanie L.
背景：拉丁裔目前是美国最大、增长最快的种族/族裔群体，并且在全国范围内获得常规初级保健来源的比例最低。拉丁裔人口结构的变化对国家未来的健康具有重大影响，特别是在慢性病方面。社区机构和诊所等在吸引社区卫生工作者 (CHW) 为患有慢性病的拉丁裔提供广泛的有形和情感支持策略方面有着悠久的历史。在本文中，我们提出了社区干预方案，旨在评估社区临床联系模型中社区卫生工作者的影响，通过电子健康记录 (EHR) 的创新利用和混合方法的应用来解决慢性病问题。将个人需求与社区和临床服务联系起来 (LINKS) 是一项为期 3 年的前瞻性匹配观察性研究，旨在检验 CHW 主导的社区临床联系在降低生活在美国-墨西哥边境三个社区的拉丁美洲人的慢性病风险和促进情绪健康方面的可行性和影响。方法：LINKS 的主要目的是在亚利桑那州南部的三个社区卫生中心与其各自的县卫生部门之间建立社区临床联系。我们的主要分析是检查项目进入后 6 至 12 个月干预的影响。我们将评估参与者与匹配的非参与者的电子病历中记录的慢性病风险因素。通过使用电子病历的前瞻性匹配观察研究设计，我们可以获得许多潜在的比较者来评估干预效果。二次分析包括对扩展研究收集的指标的组内变化进行建模。这种方法通过 EHR 系统在常规临床实践中不会收集的研究参与者的身体和情感健康以及健康行为的丰富数据来增强整体评估。讨论：LINKS 干预对于社区临床联系模型的开发具有实际意义。 LINKS 中的协作和参与方法说明了利用 EHR 和混合方法研究生成的数据收集的创新评估框架。
Background: Latinos are currently the largest and fastest growing racial/ethnic group in the United States and have the lowest rates nationally of regular sources of primary care. The changing demographics of Latino populations have significant implications for the future health of the nation, particularly with respect to chronic disease. Community-based agencies and clinics alike have a long history of engaging community health workers (CHWs) to provide a broad range of tangible and emotional support strategies for Latinos with chronic diseases. In this paper, we present the protocol for a community intervention designed to evaluate the impact of CHWs in a Community-Clinical Linkage model to address chronic disease through innovative utilization of electronic health records (EHRs) and application of mixed methodologies. Linking Individual Needs to Community and Clinical Services (LINKS) is a 3-year, prospective matched observational study designed to examine the feasibility and impact of CHW-led Community-Clinical Linkages in reducing chronic disease risk and promoting emotional well-being among Latinos living in three U.S.-Mexico border communities.Methods: The primary aim of LINKS is to create Community-Clinical Linkages between three community health centers and their respective county health departments in southern Arizona. Our primary analysis is to examine the impact of the intervention 6 to 12-months post program entry. We will assess chronic disease risk factors documented in the EHRs of participants versus matched non-participants. By using a prospective matched observational study design with EHRs, we have access to numerous potential comparators to evaluate the intervention effects. Secondary analyses include modeling within-group changes of extended research-collected measures. This approach enhances the overall evaluation with rich data on physical and emotional well-being and health behaviors of study participants that EHR systems do not collect in routine clinical practice.Discussion: The LINKS intervention has practical implications for the development of Community-Clinical Linkage models. The collaborative and participatory approach in LINKS illustrates an innovative evaluation framework utilizing EHRs and mixed methods research-generated data collection.