Trial reportMedical care2018
Why Effective Interventions Do Not Work for All Patients: Exploring Variation in Response to a Chronic Disease Management Intervention.
Trial report in Medical care, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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
19 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A scoping review of the feasibility, usability, and efficacy of digital interventions in older adults concerning physical activity and/or exercise.Frontiers in aging · 2025Pooled it
- Impact of behavioral phenotypes on response to a digital intervention to improve physical activity among postpartum individuals with hypertensive disorders of pregnancy.Hypertension in pregnancy · 2025Trial
- Trial
- Trial
- Awareness and use of a community health worker program among racial/ethnic minority adults in Philadelphia: Results from a cross-sectional community health survey.American journal of community psychology · 2026Article
- The impact and experience of a culturally adapted brief intervention for harmful alcohol use in an emergency care setting (PPKAY: Punguza Pombe Kwa Afya Yako): A case series.medRxiv : the preprint server for health sciences · 2025Article
- A Multigenerational Model of Environmental Risk for Black, Indigenous, and People of Color (BIPOC) Children and Families.Environmental health perspectives · 2024Article
- Strategies to improve implementation of cascade testing in hereditary cancer syndromes: a systematic review.NPJ genomic medicine · 2024Article
- Impact of community health workers on diabetes management in an urban United States Community with high diabetes burden through the COVID pandemic.Preventive medicine reports · 2024Article
- Association between physical activity and health literacy in patients with Parkinson's disease: an online web survey.BMC neurology · 2023Article
- The long-term benefits of early intensive therapy in chronic diseases-the legacy effect.Clinical kidney journal · 2023Review
- Is Type 2 Diabetes Mellitus a Behavioural Disorder? An Evidence Review for Type 2 Diabetes Mellitus Prevention and Remission through Lifestyle Modification.TouchREVIEWS in endocrinology · 2023Review
- Developing a research agenda for social prescribing in the UK using lessons from the US.The British journal of general practice : the journal of the Royal College of General Practitioners · 2022Article
- Changes in Blood Lipid Levels After a Digitally Enabled Cardiometabolic Preventive Health Program: Pre-Post Study in an Adult Dutch General Population Cohort.JMIR cardio · 2022Article
- Design of a randomized controlled trial of digital health and community health worker support for diabetes management among low-income patients.Contemporary clinical trials communications · 2022Article
- A pilot randomized trial of five financial incentive strategies to increase study enrollment and retention rates.Contemporary clinical trials communications · 2019Article
- Review
- Mechanisms for Community Health Worker Action on Patient-, Institutional-, and Community-Level Barriers to Primary Care in a Safety-Net Setting.The Journal of ambulatory care managementArticle
- Identifying and Addressing Individuals Resistant to Behavioral Lifestyle Treatment.American journal of lifestyle medicineReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
Abstract
backgroundHalf of all Americans have a chronic disease. Promoting healthy behaviors to decrease this burden is a national priority. A number of behavioral interventions have proven efficacy; yet even the most effective of these has high levels of nonresponse.
objectivesIn this study, we explore variation in response to an evidence-based community health worker (CHW) intervention for chronic disease management. RESEARCH
designWe used a convergent parallel design that combined a randomized controlled trial with a qualitative process evaluation that triangulated chart abstraction, in-depth interviews and participant observation. SUBJECTS: Eligible patients lived in a high-poverty region and were diagnosed with 2 or more of the following chronic diseases: diabetes, obesity, hypertension or tobacco dependence. There were 302 patients in the trial, 150 of whom were randomly assigned to the CHW intervention. Twenty patients and their CHWs were included in the qualitative evaluation.
resultsWe found minimal differences between responders and nonresponders by sociodemographic or clinical characteristics. A qualitative process evaluation revealed that health behavior change was challenging for all patients and most experienced failure (ie, gaining weight or relapsing with cigarettes) along the way. Responders seemed to increase their resolve after failed attempts at health behavior change, while nonresponders became discouraged and "shut down."
conclusionsFailure is a common and consequential aspect of health behavior change; a deeper understanding of failure should inform chronic disease interventions.
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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.