title: A Place-Based Community Health Worker Program: Feasibility and Early Outcomes, New York City, 2015.
abstract: BACKGROUND
  This study examined feasibility of a place-based community health worker (CHW) and health advocate (HA) initiative in five public housing developments selected for high chronic disease burden and described early outcomes.
  
  
  METHODS
  This intervention was informed by a mixed-method needs assessment performed December 2014-January 2015 (representative telephone survey, n=1,663; six focus groups, n=55). Evaluation design was a non-randomized, controlled quasi-experiment. Intake and 3-month follow-up data were collected February-December 2015 (follow-up response rate, 93%) on 224 intervention and 176 comparison participants, and analyzed in 2016. All participants self-reported diagnoses of hypertension, diabetes, or asthma. The intervention consisted of chronic disease self-management and goal setting through six individual CHW-led health coaching sessions, instrumental support, and facilitated access to insurance/clinical care navigation from community-based HAs. Feasibility measures included CHW service satisfaction and successful goal setting. Preliminary outcomes included clinical measures (blood pressure, BMI); disease management behaviors and self-efficacy; and preventive behaviors (physical activity).
  
  
  RESULTS
  At the 3-month follow-up, nearly all intervention participants reported high satisfaction with their CHW (90%) and HA (76%). Intervention participants showed significant improvements in self-reported physical activity (p=0.005) and, among hypertensive participants, self-reported routine blood pressure self-monitoring (p=0.013) compared with comparison participants. No improvements were observed in self-efficacy or clinical measures at the 3-month follow-up.
  
  
  CONCLUSIONS
  Housing-based initiatives involving CHW and HA teams are acceptable to public housing residents and can be effectively implemented to achieve rapid improvements in physical activity and chronic disease self-management. At 3-month assessment, additional time and efforts are required to improve clinical outcomes.
authors.affiliation: New York University School of Medicine, NYU-CUNY Prevention Research Center, New York, New York.
authors.forename: Priscilla M
authors.initials: PM
authors.lastname: Lopez
authors.affiliation: New York University School of Medicine, NYU-CUNY Prevention Research Center, New York, New York.
authors.forename: Nadia
authors.initials: N
authors.lastname: Islam
authors.affiliation: New York University School of Medicine, NYU-CUNY Prevention Research Center, New York, New York.
authors.forename: Alexis
authors.initials: A
authors.lastname: Feinberg
authors.affiliation: New York City Department of Health and Mental Hygiene, Long Island City, New York.
authors.forename: Christa
authors.initials: C
authors.lastname: Myers
authors.affiliation: New York City Department of Health and Mental Hygiene, Long Island City, New York.
authors.forename: Lois
authors.initials: L
authors.lastname: Seidl
authors.affiliation: New York City Department of Health and Mental Hygiene, Long Island City, New York.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Drackett
authors.affiliation: New York University School of Medicine, NYU-CUNY Prevention Research Center, New York, New York.
authors.forename: Lindsey
authors.initials: L
authors.lastname: Riley
authors.affiliation: New York City Housing Authority, New York, New York.
authors.forename: Andrea
authors.initials: A
authors.lastname: Mata
authors.affiliation: Community Services Society, New York, New York.
authors.forename: Juan
authors.initials: J
authors.lastname: Pinzon
authors.affiliation: Community Services Society, New York, New York.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Benjamin
authors.affiliation: City University of New York School of Public Health and Health Policy, NYU-CUNY Prevention Research Center, New York, New York.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Wyka
authors.affiliation: New York City Department of Health and Mental Hygiene, Long Island City, New York.
authors.forename: Rachel
authors.initials: R
authors.lastname: Dannefer
authors.affiliation: New York City Department of Health and Mental Hygiene, Long Island City, New York.
authors.forename: Javier
authors.initials: J
authors.lastname: Lopez
authors.affiliation: New York University School of Medicine, NYU-CUNY Prevention Research Center, New York, New York.
authors.forename: Chau
authors.initials: C
authors.lastname: Trinh-Shevrin
authors.affiliation: New York City Department of Health and Mental Hygiene, Long Island City, New York.
authors.forename: Karen
authors.initials: K
authors.lastname: Aletha Maybank
authors.affiliation: New York University School of Medicine, NYU-CUNY Prevention Research Center, New York, New York. Electronic address: lorna.thorpe@nyumc.org.
authors.forename: Lorna E
authors.initials: LE
authors.lastname: Thorpe
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003150:Community Health Workers / Q000458:organization & administration*; D019468:Disease Management; D005240:Feasibility Studies; D005260:Female; D000069576:Health Equity; D006293:Health Promotion; D006801:Humans; D008297:Male; D008875:Middle Aged; D009519:New York City; D011638:Public Housing; D000073278:Self-Management; D055815:Young Adult