Community Health Workers Help Clients Manage Blood Pressure

Submission Date: December 2017

State/Territory Submitted on the Behalf of: Kentucky

States/Territories Involved: Kentucky

Funding Source: CDC

CDC Funding:

Yes

CDC Funding (Specified):

(1305) State Public Health

Domain Addressed:

Health Systems Strategies

Public Health Issue:

• Montgomery County is a rural Kentucky county where about a fifth of the population lives below the federal poverty level and there are fewer health care providers per 1,000 residents than the state as a whole.
• Ensuring the right healthcare for persons with chronic diseases such as hypertension, can improve treatment outcomes and quality of life while reducing hospital admissions and healthcare costs.
• Community health workers (CHW) provide culturally-appropriate health information and can help their clients access the care they need.
• Despite the evidence demonstrating the benefits of CHWs for improved health outcomes, their use remains limited in Kentucky’s federally qualified health centers, which serve the state’s neediest population.

Program Action:

• The Kentucky Department for Public Health (KDPH) and the Montgomery County Health Department participate in the Appalachian Kentucky Health Care Access Network (AKHCAN), which works to increase and sustain the number of trained CHWs in Kentucky’s Appalachian counties.
• The Montgomery County Health Department enrolled more than 280 clients in their CHW program, many of whom are undocumented Latinos ineligible for health insurance coverage. CHWs in the program conduct home visits with clients to help them get better access to needed healthcare and to improve their health status. The health department maintains a close relationship with the local, federally qualified health center where many in this low-income, uninsured, and underinsured population, can receive free care.
• High blood pressure is the number one diagnosis among CHW program clients, and CHWs are applying the KDPH Care Collaborative blood pressure education protocol in their work with these clients.

Impact/Accomplishments:

• More than 250 clients get their blood pressure measured regularly and receive ongoing education on lifestyle modifications and medication adherence as a result of their enrollment in the CHW program.
• CHWs bridged cultural and linguistic barriers for their clients with high blood pressure to improve many aspects of their care and their health, for example, clients had:
  • Improved blood pressure – both systolic and diastolic blood pressure decreased
  • Increased adherence to prescribed medicine – between enrollment and 15 months of participation medication adherence went from 65% to 91% taking medications as prescribed
  • Fewer emergency room visits
  • Increased establishment of relationships with regular healthcare providers – 16% of clients obtained a primary care provider after enrollment
  • Increased medical insurance coverage – five percent of clients obtained medical insurance coverage after enrollment
• AKHCAN now promotes the expansion of employment of CHWs at healthcare facilities across the state by educating stakeholders on the economic impact of using CHWs; by supporting a CHW membership organization established in 2016; and by working to develop a state-wide CHW training curriculum based on eight core competencies in collaboration with a state workgroup.

Program Areas:

Heart Disease and Stroke

State Contact Information:

KY
Gina Brien, M.A.
Montgomery County Health Department
859-497-2441
GinaL.Brien@ky.gov

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