Efficacy and Cost Effectiveness of Community Health Worker Models in Addressing Clinical Care and Health Metrics among Under-served Hispanics with Risk Factors for Diabetes

描述(申请人提供)：15年来，亚利桑那州预防研究中心(AzPRC)一直为学术与社区合作研究、培训和能力建设提供保护伞，旨在缩小该州慢性疾病预防和控制方面的健康差距。AzPRC是慢性病预防和控制实践研究的基础，重点关注生活在亚利桑那州边境社区的拉丁裔美国人，我们处于有利地位，能够为疾控中心在营养、体育活动和肥胖问题上取得胜利做出实质性贡献。为此，AzPRC的目标和宗旨将发扬AzPRC人员和合作伙伴的现有努力，以推进国家慢性病预防和健康促进中心的使命，“支持人们和社区预防慢性病，促进人人健康”，特别是通过我们的努力：1)整合卫生系统中的循证战略；2)与公共卫生系统合作，应用和评估旨在为人们创造健康的工作、学习和娱乐场所的政策、系统和环境变化(PSE)努力；以及3)改善社区与临床的联系，以确保获得具有文化相关性的预防和促进工作，并确保其质量。在接下来的五年里，AzPRC将与亚利桑那州卫生服务部、县卫生部门、联邦合格的卫生中心和其他社区组织合作，改善亚利桑那州-索诺拉边境和全州社区的健康和福祉。AzPRC将通过在基础设施、社区参与、伙伴关系和技术援助、沟通和传播、培训和评估等方面的努力的综合影响来实现这一目标。AzPRC还将使用最先进和高效的方法，执行一项严格的以实践为基础的公共卫生研究项目，该项目将确定社区卫生工作者(CHW)实践的循证指南，以解决慢性病和相关的心理健康需求，并将这些发现转化为CHW提供的已实施和评估的预防计划模式，将致力于为服务不足的人提供初级保健的环境与县卫生部门的社区服务联系起来。在这项研究的后期阶段，在我们之前成功的全州公共卫生系统努力的指导下，以及对《平价医疗法案》和其他政策努力推动的CHW不断演变的补偿机制的回应，这一计划在全州的可持续性和可扩充性将是重点。

DESCRIPTION (provided by applicant): For over 15 years, the Arizona Prevention Research Center (AzPRC) has provided an umbrella for academic- community collaborative research, training and capacity building efforts to reduce health disparities in chronic disease in the state The AzPRC foundation of practice-based research on chronic disease prevention and control, with a focus on Latinos living in Arizona border communities, well positions us to substantively contribute to CDC's winnable battle of nutrition, physical activity and obesity. In doing so, AzPRC goals and objectives will carry forward existing efforts of AzPRC personnel and partners to further the National Center for Chronic Disease Prevention and Health Promotion's mission "to support people and communities in preventing chronic disease and promoting health for all", specifically through our efforts to: 1) integrating evidence-based strategies across health systems; 2) working with public health systems to apply and evaluate policy, systems & environmental change (PSE) efforts designed to create healthy places for people to work, learn and play; and 3) improving community-clinical linkages to ensure access to, and quality of, culturally relevant prevention and promotion efforts. Over the next five years the AzPRC will work with the Arizona Department of Health Services, County Health Departments, Federally Qualified Health Centers and other community organizations to improve the health and wellbeing of communities on the Arizona-Sonora Border and statewide. The AzPRC will achieve this goal through the integrated impact of efforts in infrastructure, community engagement, partnering and technical assistance; communication and dissemination, training, and evaluation. The AzPRC, using state of the art and efficient methodologies, will also execute a rigorous practice- based Public Health research project that will identify evidence-based guidelines for Community Health Worker (CHW) practices to address chronic disease and interrelated mental health needs, and translate these findings into an implemented and evaluated CHW-delivered preventive program model linking primary care settings dedicated to reaching the under-served with community services of county health departments. In the latter stages of this research, guiding by our prior successful statewide public health system-based efforts and being responsive to evolving reimbursement mechanism of CHWs promoted by the Affordable Care Act and other policy efforts, the sustainability and scalable of this program throughout the State will be focal.