A Cohort Review Approach Evaluating Community Health Worker Programs in New York City, 2015–2017

A Cohort Review Approach Evaluating Community Health Worker Programs in New York City, 2015–2017

PROGRAM EVALUATION BRIEF — Volume 16 — July 11, 2019

Alexis Feinberg, MPH1; Lois Seidl, MPH2; Rachel Dannefer, MPH, MIA2; Katarzyna Wyka, PhD3; Elizabeth Drackett, MPA2; La’Shawn Brown-Dudley, MS2; Nadia Islam, PhD1; Lorna E. Thorpe, PhD1 (View author affiliations)

Suggested citation for this article: Feinberg A, Seidl L, Dannefer R, Wyka K, Drackett E, Brown-Dudley L, et al. A Cohort Review Approach Evaluating Community Health Worker Programs in New York City, 2015–2017. Prev Chronic Dis 2019;16:180623. DOI: http://dx.doi.org/10.5888/pcd16.180623external icon.

PEER REVIEWED

On This Page

• Abstract
• Introduction
• Purpose and Objective
• Intervention Approach
• Evaluation Methods
• Results
• Implications for Public Health
• Acknowledgments
• Author Information
• References
• Tables

Summary

What is already known about this topic?

Findings from community health worker (CHW) interventions targeting chronic disease prevention and management demonstrate inconsistent results, which may be attributable to funding mechanisms. Monitoring tools developed to address resource constraints, such as the cohort review, have not been used previously to evaluate CHW programs.

What is added by this report?

We applied a cohort review approach as an evaluation framework for a community-focused CHW intervention in New York City. We assessed program implementation and outcomes during the first 2 years of the program. The cohort approach highlighted 6-month outcome successes related to hypertension and diabetes control and identified workload challenges affecting recruitment and retention.

What are the implications for public health practice?

Adapting a cohort monitoring approach can be useful for evaluating the implementation of CHW programs. Such an approach also addresses issues associated with resource constraints and limited program duration.

Abstract

The objective of this study was to describe how a cohort review approach was applied as an evaluation framework for a community health worker intervention among adult residents in 5 public housing developments in New York City in 2015–2017. The cohort review approach involved systematically monitoring participants engaged in the Harlem Health Advocacy Partners program during a given time period (“cohort”) to assess individual outcomes and program performance. We monitored participation status (completed, still active, disengaged, on leave, or died) and health outcomes. In this example of a cohort review, levels of enrollment and program disengagement were higher in cohort 1 than in cohort 2. For 6-month health outcomes, the percentage of participants with hypertension who had controlled blood pressure was static in cohort 1 and improved significantly in cohort 2. The percentage of participants with diabetes who self-reported controlled hemoglobin A1c increased significantly in cohort 1 at 6-month follow-up. The cohort approach highlighted important outcome successes and identified workload challenges affecting recruitment and retention.