ArticleInternational journal for equity in health2019
Integrating community health representatives with health care systems: clinical outcomes among individuals with diabetes in Navajo Nation.
Article in International journal for equity in health, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03326206 (Evaluating the Navajo Community Outreach and Patient Empowerment), which is not on this map. Cited by 10 papers, 1 of them a synthesis that pooled it.
What it found
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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.
Evaluating the Navajo Community Outreach and Patient Empowerment (COPE) Program
Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.
- Effective primary care management of type 2 diabetes for indigenous populations: A systematic review.PloS one · 2022Pooled it
- Extending the boundaries of care: Collaboratively planning connections between rehabilitation and community resources for chronic pain self-management.Canadian journal of pain = Revue canadienne de la douleur · 2026Article
- Thoughts on the construction of public health informatization for community health archives grass roots management system.Frontiers in public health · 2023Article
- Empowerment-based support program for vulnerable populations living with diabetes, obesity or high blood pressure: a scoping review.BMC public health · 2022Article
- The Role of the Indigenous Patient Navigator: A Scoping Review.The Canadian journal of nursing research = Revue canadienne de recherche en sciences infirmieres · 2022Article
- Diné Navajo Resilience to the COVID-19 pandemic.PloS one · 2022Article
- Community Outreach for Navajo People Living with Diabetes: Who Benefits Most?Preventing chronic disease · 2020Article
- Barbershop Management of Hypertension in the African American Population: Pitfalls and Opportunities for Extension to Other Underserved Communities.Current cardiology reports · 2020Review
- Community-based outreach associated with increased health utilization among Navajo individuals living with diabetes: a matched cohort study.BMC health services research · 2020Observational
- Qualitative evaluation of a community health representative program on patient experiences in Navajo Nation.BMC health services research · 2020Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWe studied the impact of Community Outreach and Patient Empowerment (COPE) intervention to support Community Health Representatives (CHR) on the clinical outcomes of patients living with diabetes in the Navajo Nation extending into the States of Arizona, Utah, and New Mexico. The COPE intervention integrated CHRs into healthcare teams by providing a structured approach to referrals and home visits.
methodsWe abstracted routine clinical data from the Indian Health Service's information system on individuals with diabetes mellitus seen at participating clinical sites from 2010 to 2014. We matched 173 COPE participants to 2880 patients with similar demographic and clinical characteristics who had not participated in COPE. We compared the changes in clinical outcomes between the two groups using linear mixed models.
resultsOver the four years of the study, COPE patients had greater improvements in glycosylated hemoglobin (- 0.56%) than non-COPE participants (+ 0.07%) for a difference in differences of 0.63% (95% confidence interval (CI): 0.50, 0.76). Low-density lipoprotein fell more steeply in the COPE group (- 10.58 mg/dl) compared to the non-COPE group (- 3.18 mg/dl) for a difference in differences of 7.40 mg/dl (95%CI: 2.00, 12.80). Systolic blood pressure increased slightly more among COPE (2.06 mmHg) than non-COPE patients (0.61 mmHg). We noted no significant change for body mass index in either group.
conclusionStructured outreach by Community Health Representatives as part of an integrated care team was associated with improved glycemic and lipid levels in the target Navajo population.
trial registrationTrial registration: NCT03326206. Registered 31 October 2017 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/study/NCT03326206.
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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.