Health literacy, health outcomes and community health worker utilization: a cohort study in HIV primary care.
Health literacy, health outcomes and community health worker utilization: a cohort study in HIV primary care.
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DOI：
10.1186/s12913-022-08634-7
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发表时间：
2022-10-17
影响因子：
2.8
通讯作者：
中科院分区：
文献类型：
--
作者：
艾滋病毒感染者（PWH）有复杂的需求，而卫生知识有限的人始终缺乏与艾滋病毒相关的知识和健康结果。促进改善PWH结果的一项战略是将社区卫生工作者纳入护理小组。本队列研究考察了健康素养对参加健康护理干预的PWH临床结果和健康护理服务利用的影响。第二个目的是描述CHW遭遇的最常见目的。PWH （n = 209）纳入CHW干预，并完成6个月的随访评估访问。使用BRIEF工具在基线上测量卫生素养水平，并将其分为不充分、边缘和适当的卫生素养。调整后的logistic回归评估了健康素养对病毒载量抑制、6个月随访时的HIV初级保健就诊、卫生保健的利用和卫生保健的目的的影响。CHW会面的目的包括后勤支持、陪同预约、交通协调、具体服务、指导和情感支持。线性回归评估了CHW接触目的与CHW利用之间的关系。健康素养不足的个体更有可能接受卫生保健员的指导（p = 0.029），而边缘健康素养的个体更有可能在6个月时接受艾滋病毒初级保健访问（p = 0.044）。接受交通协调、具体服务、指导和情感支持的个体有更多的CHW遭遇。就诊目的与就诊频次高度相关，而健康素养状况与就诊频次无关。这表明，无论卫生知识水平如何，接受这些服务的个人都需要来自卫生工作者的更多帮助。培训健康护理员在初次探访客户时进行全面的社会需要评估和筛查风险因素，可以作为护理团队的一部分，识别资源并指导健康护理员提供服务。在线版本包含补充材料，可在10.1186/s12913-022-08634-7获得。
People with HIV (PWH) have complex needs, and those with limited health literacy consistently have poorer HIV-related knowledge and health outcomes. One strategy to facilitate better outcomes for PWH is the inclusion of community health workers (CHWs) into care teams. This cohort study examines the effect of health literacy on clinical outcomes and utilization of CHW services among PWH enrolled in a CHW intervention. The secondary aim is to characterize most common purposes of CHW encounters. PWH (n = 209) enrolled in a CHW intervention with completed 6-month follow-up evaluation visits were included. Health literacy level was measured at baseline with the BRIEF tool and categorized into inadequate, marginal, and adequate health literacy. Adjusted logistic regressions assessed the effect of health literacy on viral load suppression, HIV primary care visits at 6-month follow-up, CHW utilization and purpose of CHW encounter. Purpose of CHW encounters included logistical support, accompany to appointment, transportation coordination, concrete services, coaching, and emotional support. Linear regression assessed the association between purpose of CHW encounters and CHW utilization. Individuals with inadequate health literacy were more likely to receive coaching from CHWs (p = 0.029), and individuals with marginal health literacy were more likely to have an HIV primary care visit at 6 months (p = 0.044). Individuals receiving transportation coordination, concrete services, coaching, and emotional support had more total CHW encounters. Purpose of encounter was highly correlated with frequency of CHW encounters, while health literacy status was not. This suggests individuals receiving these services require more assistance from CHWs, regardless of health literacy level. Training CHWs to conduct comprehensive social needs assessment and screening for risk factors at the initial visit with clients can identify resources and guide CHW service delivery as part of the care team. The online version contains supplementary material available at 10.1186/s12913-022-08634-7.
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影响因子：
4.5
作者：
Sprague Martinez L;Davoust M;Rajabiun S;Baughman A;Bachman SS;Bowers-Sword R;Campos Rojo M;Sullivan M;Drainoni ML
通讯作者：
Drainoni ML
患者导航员在为多重诊断的艾滋病毒阳性无家可归者建立医疗之家中的作用。
DOI：
10.1097/phh.0000000000000512
发表时间：
2017
期刊：
Journal of public health management and practice : JPHMP
影响因子：
--
作者：
Sarango M;de Groot A;Hirschi M;Umeh CA;Rajabiun S
通讯作者：
Rajabiun S
影响因子：
4.9
作者：
Bradford, Judith B.;Coleman, Sharon;Cunningham, William
通讯作者：
Cunningham, William
影响因子：
4.9
作者：
Davoust, Melissa;Drainoni, Mari-Lynn;Martinez, Linda Sprague
通讯作者：
Martinez, Linda Sprague
影响因子：
4.4
作者：
Maulsby, Cathy;Charles, Vignetta;Holtgrave, David
通讯作者：
Holtgrave, David