Community health worker navigation to improve allostatic load: The Integrated Population Health (IPOP) study
Background: Social determinants of health (SDOH) and cumulative stress contribute to chronic disease development. The physiological response to repeated stressors typical of lower-income environments can be measured through allostatic load – a composite measure of cardiovascular, metabolic, and immu...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-12-01
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| Series: | Contemporary Clinical Trials Communications |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2451865423001813 |
| _version_ | 1827582814219927552 |
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| author | Heather Kitzman Leilani Dodgen Cristian Vargas Mahbuba Khan Aisha Montgomery Meera Patel Brittany Ajoku Patricia Allison Anne Marie Strauss Michael Bowen |
| author_facet | Heather Kitzman Leilani Dodgen Cristian Vargas Mahbuba Khan Aisha Montgomery Meera Patel Brittany Ajoku Patricia Allison Anne Marie Strauss Michael Bowen |
| author_sort | Heather Kitzman |
| collection | DOAJ |
| description | Background: Social determinants of health (SDOH) and cumulative stress contribute to chronic disease development. The physiological response to repeated stressors typical of lower-income environments can be measured through allostatic load – a composite measure of cardiovascular, metabolic, and immune variables. Healthcare systems have employed patient navigation for social and medical needs to improve SDOH that has demonstrated limited impact on chronic disease outcomes. This study evaluates a novel community health worker navigation intervention developed using behavioral theories to improve access to social and medical services and provide social support for poverty stressed adults. Methods: The Integrated Population Health Study (IPOP) study is a randomized, parallel two arm study evaluating community health worker navigation in addition to an existing integrated population health program (IPOP CHW) as compared to Usual Care (population health program only, IPOP) on allostatic load and chronic disease risk factors. IPOP CHW participants receive a 10-month navigation intervention. Results: From 381 screened individuals, a total of 202 participants (age 58.15 ± 12.03 years, 74.75 % female, 79.21 % Black/African American, 17.33 % Hispanic) were enrolled and randomized to IPOP CHW (n = 100) or IPOP Only (n = 102). Conclusion: This study will evaluate whether CHW navigation, using a structured intervention based on health behavior theories, can effectively guide poverty stressed individuals to address social and medical needs to improve allostatic load—a composite of cumulative stress and physiological responses. Healthcare systems, nonprofit organizations, and governmental entities are interested in addressing SDOH to improve health, thus developing evidence-based interventions could have broad clinical and policy implications. |
| first_indexed | 2024-03-08T22:57:02Z |
| format | Article |
| id | doaj.art-eb0468fa7f254b92888b6b4665c34527 |
| institution | Directory Open Access Journal |
| issn | 2451-8654 |
| language | English |
| last_indexed | 2024-03-08T22:57:02Z |
| publishDate | 2023-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Contemporary Clinical Trials Communications |
| spelling | doaj.art-eb0468fa7f254b92888b6b4665c345272023-12-16T06:08:40ZengElsevierContemporary Clinical Trials Communications2451-86542023-12-0136101235Community health worker navigation to improve allostatic load: The Integrated Population Health (IPOP) studyHeather Kitzman0Leilani Dodgen1Cristian Vargas2Mahbuba Khan3Aisha Montgomery4Meera Patel5Brittany Ajoku6Patricia Allison7Anne Marie Strauss8Michael Bowen9Peter J. O'Donnell Jr. School of Public Health, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA; Baylor Scott and White Health, 4500 Spring Ave, Dallas, TX, 75210, USA; Corresponding author. UT Southwestern Medical Center, OSPH, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA.Baylor Scott and White Health, 4500 Spring Ave, Dallas, TX, 75210, USABaylor Scott and White Health, 4500 Spring Ave, Dallas, TX, 75210, USABaylor Scott and White Health, 4500 Spring Ave, Dallas, TX, 75210, USABaylor Scott and White Health, 4500 Spring Ave, Dallas, TX, 75210, USAPeter J. O'Donnell Jr. School of Public Health, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USABaylor Scott and White Health, 4500 Spring Ave, Dallas, TX, 75210, USABaylor Scott and White Health, 4500 Spring Ave, Dallas, TX, 75210, USABaylor Scott and White Health, 4500 Spring Ave, Dallas, TX, 75210, USADepartment of Internal Medicine, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USABackground: Social determinants of health (SDOH) and cumulative stress contribute to chronic disease development. The physiological response to repeated stressors typical of lower-income environments can be measured through allostatic load – a composite measure of cardiovascular, metabolic, and immune variables. Healthcare systems have employed patient navigation for social and medical needs to improve SDOH that has demonstrated limited impact on chronic disease outcomes. This study evaluates a novel community health worker navigation intervention developed using behavioral theories to improve access to social and medical services and provide social support for poverty stressed adults. Methods: The Integrated Population Health Study (IPOP) study is a randomized, parallel two arm study evaluating community health worker navigation in addition to an existing integrated population health program (IPOP CHW) as compared to Usual Care (population health program only, IPOP) on allostatic load and chronic disease risk factors. IPOP CHW participants receive a 10-month navigation intervention. Results: From 381 screened individuals, a total of 202 participants (age 58.15 ± 12.03 years, 74.75 % female, 79.21 % Black/African American, 17.33 % Hispanic) were enrolled and randomized to IPOP CHW (n = 100) or IPOP Only (n = 102). Conclusion: This study will evaluate whether CHW navigation, using a structured intervention based on health behavior theories, can effectively guide poverty stressed individuals to address social and medical needs to improve allostatic load—a composite of cumulative stress and physiological responses. Healthcare systems, nonprofit organizations, and governmental entities are interested in addressing SDOH to improve health, thus developing evidence-based interventions could have broad clinical and policy implications.http://www.sciencedirect.com/science/article/pii/S2451865423001813Low-incomeNavigationCommunity health workerChronic diseaseAllostatic loadStress |
| spellingShingle | Heather Kitzman Leilani Dodgen Cristian Vargas Mahbuba Khan Aisha Montgomery Meera Patel Brittany Ajoku Patricia Allison Anne Marie Strauss Michael Bowen Community health worker navigation to improve allostatic load: The Integrated Population Health (IPOP) study Contemporary Clinical Trials Communications Low-income Navigation Community health worker Chronic disease Allostatic load Stress |
| title | Community health worker navigation to improve allostatic load: The Integrated Population Health (IPOP) study |
| title_full | Community health worker navigation to improve allostatic load: The Integrated Population Health (IPOP) study |
| title_fullStr | Community health worker navigation to improve allostatic load: The Integrated Population Health (IPOP) study |
| title_full_unstemmed | Community health worker navigation to improve allostatic load: The Integrated Population Health (IPOP) study |
| title_short | Community health worker navigation to improve allostatic load: The Integrated Population Health (IPOP) study |
| title_sort | community health worker navigation to improve allostatic load the integrated population health ipop study |
| topic | Low-income Navigation Community health worker Chronic disease Allostatic load Stress |
| url | http://www.sciencedirect.com/science/article/pii/S2451865423001813 |
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