Observational studyMedical care2017
Impact of Community Health Workers on Elderly Patients' Advance Care Planning and Health Care Utilization: Moving the Dial.
Observational study in Medical care, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed.
- Quasi-Experimental Evaluation of LifeCourse on Utilization and Patient and Caregiver Quality of Life and Experience.The American journal of hospice & palliative care · 2019Trial
- Perspectives of Former Caregivers of Black Older Adults Living With Dementia on Advance Care Planning.Journal of gerontological nursing · 2025Article
- Top Ten Tips Palliative Care Clinicians Should Know About End-of-Life Doulas.Journal of palliative medicine · 2025Article
- Geriatric-focused education for community health workers: a dementia training that effectively provides knowledge and skills to address dementia within the scope of practice of this public health workforce.Frontiers in public health · 2025Article
- Community health worker training on older adults: A qualitative needs assessment.Journal of the American Geriatrics Society · 2024Article
- Non-emergency department (ED) interventions to reduce ED utilization: a scoping review.BMC emergency medicine · 2024Article
- A model for community-led peer-facilitated advance care planning workshops for the public.Palliative care and social practice · 2023Article
- "This is how I want it": Exploring the use of a workbook with persons with dementia to support advance care planning engagement.Dementia (London, England) · 2022Article
- The development of a questionnaire to assess the willingness of Chinese community health workers to implement advance care planning.BMC palliative care · 2022Article
- Evaluation of the LIGHT Curriculum: An African American Church-Based Curriculum for Training Lay Health Workers to Support Advance Care Planning, End-of-Life Decision Making, and Care.Journal of palliative medicine · 2022Article
- "People are more afraid of a dementia diagnosis than of death": The challenges of supporting advance care planning for persons with dementia in community settings.Frontiers in dementia · 2022Article
- Improving End-of-Life Care for People with Dementia in LTC Homes During the COVID-19 Pandemic and Beyond.Canadian geriatrics journal : CGJ · 2021Article
- Dissemination, use, and impact of a community-based, conversational advance care planning intervention: ripple effects of the Swedish DöBra cards.Palliative care and social practice · 2021Article
- How to Screen Suitable Service Improve Community Health Care Services by University Students in Taiwan.International journal of environmental research and public health · 2020Article
- LIGHT: A Church-Based Curriculum for Training African American Lay Health Workers to Support Advance Care Planning and End-of-Life Decision-Making.Health equity · 2020Article
- Using Implementation Science to Further the Adoption and Implementation of Advance Care Planning in Rural Primary Care.Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing · 2020Review
- Leveraging In-Home Supportive Services Programs to Engage People in Advance Care Planning: Input from Staff, Providers, and Client Stakeholders.Journal of palliative medicine · 2019Article
- Emergency Department Use by Community-Dwelling Individuals With Dementia in the United States: An Integrative Review.Journal of gerontological nursing · 2018Review
- Clarifying Values and Preferences for Care Near the End of Life: The Role of a New Lay Workforce.Journal of community health · 2017Article
- Is Theory Guiding Our Work? A Scoping Review on the Use of Implementation Theories, Frameworks, and Models to Bring Community Health Workers into Health Care Settings.Journal of public health management and practice : JPHMPArticle
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundAdvance care planning (ACP) is recommended for all persons to ensure that the care they receive aligns with their values and preferences.
objectiveTo evaluate an ACP intervention developed to better meet the needs and priorities of persons with chronic diseases, including mild cognitive impairment. RESEARCH
designA year-long, pre-post intervention using lay community health workers [care coordinator assistants (CCAs)] trained to conduct and document ACP conversations with patients during home health visits with pre-post evaluation. SUBJECTS: The 818 patients were 74.2 years old (mean); 78% women; 51% African American; 43% white. MEASURES: Documentation of ACP conversation in electronic health record fields and health care utilization outcomes.
resultsIn this target population ACP documentation rose from 3.4% (pre-CCA training) to 47.9% (post) of patients who had at least 1 discussion about ACP in the electronic health record. In the 1-year preintervention period, there were no differences in admissions, emergency department (ED) visits, and outpatient visits between patients who did and did not have ACP discussion. After adjusting for prior hospitalization and ED use histories, ACP discussions were associated with a 34% less probability of hospitalization (hazard ratios, 0.66; 95% confidence interval, 0.45-0.97), and similar effects are apparent on ED use independent of age and prior ED use effects.
conclusionsPatients with chronic diseases including mild cognitive impairment can engage in ACP conversations with trusted home health care providers. Having ACP conversation is associated with significant reduction in seeking urgent health care and in hospitalizations.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.