Effectiveness of multicultural health workers in chronic disease prevention and self-management in culturally and linguistically diverse populations: a systematic literature review

2013 ◽  
Vol 19 (1) ◽  
pp. 14 ◽  
Author(s):  
Janny Goris ◽  
Nera Komaric ◽  
Amanda Guandalini ◽  
Daniel Francis ◽  
Ellen Hawes
Keyword(s):  
Health Care ◽  
Chronic Disease ◽  
Disease Prevention ◽  
Health Workers ◽  
Linguistically Diverse ◽  
Chronic Disease Prevention ◽  
Culturally And Linguistically Diverse ◽  
Self Management ◽  
Primary Health ◽  
Multicultural Health

With a large and increasing culturally and linguistically diverse (CALD) population, the Australian health care system faces challenges in the provision of accessible culturally competent health care. Communities at higher risk of chronic disease include CALD communities. Overseas, multicultural health workers (MHWs) have been increasingly integrated in the delivery of culturally relevant primary health care to CALD communities. The objective of this systematic review was to examine the effectiveness of MHW interventions in chronic disease prevention and self-management in CALD populations with the aim to inform policy development of effective health care in CALD communities in Australia. A systematic review protocol was developed and computerised searches were conducted of multiple electronic databases from 1 January 1995 until 1 November 2010. Thirty-nine studies were identified including 31 randomised controlled trials. Many of the studies focussed on poor and underserved ethnic minorities. Several studies reported significant improvements in participants’ chronic disease prevention and self-management outcomes and meta-analyses identified a positive trend associated with MHW intervention. Australian Government policies express the need for targeted inventions for CALD communities. The broader systemic application of MHWs in Australian primary health care may provide one of the most useful targeted interventions for CALD communities.

scholarly journals Evaluating the integration of chronic disease prevention and management services into primary health care

2013 ◽  
Vol 13 (1) ◽  
Author(s):  
Martin Fortin ◽  
Maud-Christine Chouinard ◽  
Tarek Bouhali ◽  
Marie-France Dubois ◽  
Cynthia Gagnon ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Chronic Disease ◽  
Disease Prevention ◽  
Chronic Disease Prevention ◽  
Primary Health ◽  
Management Services

Chronic Disease Prevention: Tobacco, Physical Activity, and Nutrition for a Healthy Start: A Vital Direction for Health and Health Care

2016 ◽  
Vol 6 (9) ◽  
Author(s):  
William H. Dietz ◽  
◽  
Ross C. Brownson ◽  
Clifford E. Douglas ◽  
John J. Dreyzehner ◽  
...  
Keyword(s):  
Physical Activity ◽  
Health Care ◽  
Chronic Disease ◽  
Disease Prevention ◽  
Healthy Start ◽  
Chronic Disease Prevention

scholarly journals Editorial: CoAG and Primary Health Reform

2006 ◽  
Vol 12 (1) ◽  
pp. 6
Author(s):  
Hal Swerissen
Keyword(s):  
Chronic Disease ◽  
Disease Prevention ◽  
Community Care ◽  
National Policy ◽  
Chronic Disease Prevention ◽  
Policy Framework ◽  
Policy And Practice ◽  
Primary Health ◽  
Effective Delivery ◽  
Australian Bureau Of Statistics

Chronic disease prevention and management, integration and community care continue to be key themes for primary health and community care as the papers in this issue of the Journal attest. Three quarters of Australians have an ongoing chronic illness (Australian Bureau of Statistics, 2006). The Council of Australian Governments has recently emphasised the importance of health promotion and disease prevention (Council of Australian Governments, 2006), but to date proposals for action have been disappointing. There is now a plethora of research on these issues and innovative policy and practice to deal with them. There is little doubt that primary health and community care programs are important for the effective delivery of chronic disease prevention. Yet, it remains difficult to get concrete progress towards a national policy framework for primary health and community care. Instead we have incremental, piecemeal attempts at reform. Why is this so?

Transformacion Para Salud: A Patient Navigation Model for Chronic Disease Self-management

2012 ◽  
Vol 17 (2) ◽  
Author(s):  
Christina Esperat ◽  
Debra Flores ◽  
Linda McMurry ◽  
Du Feng ◽  
Huaxin Song ◽  
...  
Keyword(s):  
Health Care ◽  
Chronic Disease ◽  
Health Care Services ◽  
Patient Navigation ◽  
Health Workers ◽  
Underserved Populations ◽  
Cost Effective ◽  
Self Management ◽  
Patient Navigator ◽  
Demonstration Program

Increased cost of chronic illnesses in United States is an urgent call to develop a cost effective approach to improve chronic disease self-management, especially among vulnerable populations. An emerging role for professionals and paraprofessionals is the patient navigator. We present an example of a conceptual framework, Transformation for Health, developed to underpin the training of certified community health workers (CHW) to deliver health care, preventive services, and health education for underserved populations to promote chronic disease self-management. Transformacion Para Salud (TPS), a patient navigation model for chronic disease self-management, was a two year demonstration program to develop a culturally sensitive intervention to facilitate patient behavior changes. Patients involved in the TPS intervention showed improvements in clinical and behavioral outcomes after twelve months of intervention. This article describes the conceptual basis and implementation of the TPS and discusses program evaluation, specific intervention outcomes, and implications for practice. Use of CHWs in the patient navigator role demonstrated a cost effective method to improve access to quality, cost-effective, primary health care services as well as to facilitate chronic disease self-management.

Small-scale rural pilot programs in chronic illness management - what next?

2003 ◽  
Vol 9 (3) ◽  
pp. 114
Author(s):  
PW Harve y ◽  
PD Mill s ◽  
G Misa n ◽  
K Warre n
Keyword(s):  
Health Care ◽  
Chronic Disease ◽  
Chronic Illness ◽  
Self Management ◽  
Small Scale ◽  
Illness Management ◽  
Care Services ◽  
Primary Health ◽  
Pilot Programs ◽  
Chronic Illness Management

In recent years, rural SA has been the recipient of significant funding to support a range of new primary health care initiatives. Much of this funding, additional to normal recurrent budgets in our health system, has facilitated effective change and development through demonstration and research projects across the state. The resultant work involves programs such as: ? coordinated care trials (COAG) ? more allied health services (MAHS) ? Commonwealth regional health service initiatives (CRHS) ? quality use of medicines (QUM) ? community packages for aged care services ? Indigenous chronic disease self-management pilot programs (CDSM) ? chronic disease self-management (CDSM) programs - Sharing Health Care SA ? chronic disease self-management (CDSM) programs in Indigenous communities. In addition to the resources listed above, funding was also provided by the Commonwealth to establish the South Australian Centre for Rural and Remote Health (SACRRH) and develop the University Department of Rural Health in Whyalla. While this new funding has led to substantial developmental work in chronic illness management in particular, one needs to ask whether the time might not be right now for these hitherto small-scale change initiatives to be transformed into ongoing mainstream programs, informed and guided by research outcomes to date. Is it time to move beyond tentative chronic illness programs and into mainstream reform? We have shown that there is much to be gained, both for patients and for the system, from improved coordination of primary care services and initiatives such as self-management programs for patients with chronic conditions. Better management leads to improved patient health outcomes and can reduce demand for unplanned hospital and emergency services. Many admissions to rural hospitals requiring expensive services, in terms of infrastructure and staffing, could be either prevented, or patients could be managed more effectively in the community as part of a wider primary health care program.

scholarly journals Empowered Community Leadership for Chronic Disease Prevention: Context Matters

2020 ◽  
Vol 35 (2) ◽  
Author(s):  
Robert Mayberry ◽  
Pamela Daniels ◽  
Robina Josiah Willock ◽  
Fengxia Yan
Keyword(s):  
Chronic Disease ◽  
Disease Prevention ◽  
Youth Violence ◽  
Health Workers ◽  
Community Leadership ◽  
Chronic Disease Prevention ◽  
Leadership Role ◽  
Prevention Behavior ◽  
The Many ◽  
Sustainable Capacity

Meaningful actions to reduce the disproportionate chronic disease burden in health-disparate, often segregated, and healthcare-vulnerable communities are challenging as there are many known and unknown multilevel factors that influence chronic disease prevention behavior. Despite the many challenges, community capacity can be built to facilitate prevention behavioral change. Community leadership among residents becomes that catalyst in building a sustainable capacity for chronic disease prevention (i.e., preventing diabetes, youth violence, or a novel disease) within the context of socioeconomic and other vulnerabilities. This article discusses the leadership role of community health workers (CHWs) as informed and empowered residents to catalyze multilevel prevention behavior change.

Identifying inequities in an urban Latin American population: a cross-sectional study in Australian primary health care

2020 ◽  
Vol 26 (2) ◽  
pp. 140
Author(s):  
Luis Sanchez ◽  
Tracey Johnson ◽  
Suzanne Williams ◽  
Geoffrey Spurling ◽  
Joanne Durham
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Chronic Disease ◽  
Latin American ◽  
Linguistically Diverse ◽  
Cross Sectional Study ◽  
Culturally And Linguistically Diverse ◽  
Ageing Population ◽  
Sectional Study ◽  
Cross Sectional

In Australia, people from culturally and linguistically diverse backgrounds often face inequitable health outcomes and access to health care. An important, but under-researched, population is people of Latin American descent. A cross-sectional study obtained clinical data on Latin American Spanish-speaking patients from Brisbane’s south-west. Extracted data included demographic characteristics, risk factors, chronic disease and service use. A total of 382 people (60.5% female, 39.5% male), mainly from El Salvador and Chile and predominantly older people (70% over 50 years), were identified. Compared with the general Australian population, the proportion of people with dyslipidaemia, diabetes, arthritis and musculoskeletal, mental health disorders and being obese or overweight was high. There was also a higher use of the 20–40min general medicine consultation than in the general population. The proportion of patients receiving health promotion and chronic disease management activities was higher than in other reports. However, there were gaps in the provision of these services. The study shows an ageing population group with significant risk factors and an important burden of chronic disease and comorbidity. Addressing inequalities in health for culturally and linguistically diverse populations demands improvements in healthcare delivery and targeted actions based on a solid understanding of their complex health needs and their health, social and cultural circumstances.

scholarly journals Using a co-design process to develop an integrated model of care for delivering self-management intervention to multi-morbid COPD people in rural Nepal

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Uday Narayan Yadav ◽  
Jane Lloyd ◽  
Kedar Prasad Baral ◽  
Narendra Bhatta ◽  
Suresh Mehta ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Social Care ◽  
Health Workers ◽  
Integrated Model ◽  
Design Approach ◽  
Self Management ◽  
Model Of Care ◽  
Primary Health ◽  
Rural Nepal

Abstract Background People with chronic obstructive pulmonary disease (COPD) in Nepal are not receiving adequate support to self-manage their chronic conditions, and primary health care can play a key role in the effective management of these. In this study, we aimed to develop a model of care, using a co-design approach, for delivering evidence-based biomedical and psycho-social care to support self-management for people with multi-morbid COPD in rural Nepal. Methods A co-design approach, guided by the five stages of the design thinking model, was used for this study. Layering on “empathize” and “define” phases, we ideated a model of care that was further refined in a “prototype” stage, which included a series of consultative meetings and a 1-day co-design workshop with stakeholders. This co-design process involved a wide range of stakeholders from Nepal, including people with COPD and their families, community representatives, local government representatives, primary care practitioners, community health workers, policymakers, state-level government representatives and academics. Results Through our co-design approach, a model of integrated care for delivering evidence-based biomedical and psycho-social care to support self-management for people with multi-morbid COPD was designed. The integrated model of care included: screening of the community members aged > 40 years or exhibiting symptoms for COPD and management of symptomatic patients within primary health care, establishing referral pathways for severe cases to and from secondary/tertiary-level health care and establishing a community-based support system. It involved specific roles for community health workers, patients and their caregivers and community representatives. It was built on existing services and programmes linking primary health care centres and tertiary-level health facilities. Conclusion The co-design approach is different from the currently dominant approach of rolling out models of care, which were designed elsewhere with minimal community engagement. In our study, the co-design approach was found to be effective in engaging various stakeholders and in developing a model of care for rural Nepal. This grassroots approach is more likely to be acceptable, effective and sustainable in rural Nepal. Further research is required to test the effectiveness of an integrated model of care in delivering self-management support for people with multi-morbid COPD in rural Nepal.

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