Evidence map›Paper›PMID 31914997›Full record

Observational studyBMC health services research2020

Qualitative evaluation of a community health representative program on patient experiences in Navajo Nation.

Amber Lalla, Shine Salt, Elizabeth Schrier, Christian Brown, Cameron Curley, Olivia Muskett, Mae-Gilene Begay, Lenora Shirley, Clarina Clark, Judy Singer and 2 more

Registry-linked trialOpen access · goldAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMC health services research, 2020. 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 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
4.0field-weighted citation impact, top 6% of its field
1 · What the graph read from 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.

2 · The registry

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.

NCT03326206 completednot on this map

Evaluating the Navajo Community Outreach and Patient Empowerment (COPE) Program

TypeobservationalSponsorBrigham and Women's HospitalRan2013 to 2015Enrolled28,813ConditionsDiabetes Mellitus, Metabolic Syndrome, Hypertension, Chronic Disease
3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
  7. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 6 institutions in 1 country.

Amber LallaUniversity of New Mexico, 2425 Camino de Salud, Albuquerque, NM, 87106, USA.
Shine SaltDivision of Global Health Equity, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA.
Elizabeth SchrierNorthwestern University, 633 Clark St, Evanston, IL, 60208, USA.
Christian BrownDivision of Global Health Equity, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA.
Cameron CurleyDivision of Global Health Equity, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA.
Olivia MuskettDivision of Global Health Equity, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA.
Mae-Gilene BegayNavajo Nation Community Health Representative & Outreach Program, Navajo Nation Department of Health, Hwy 264 and St. Michael Road, St Michael, AZ, 86511, USA.
Lenora ShirleyNavajo Nation Community Health Representative & Outreach Program, Navajo Nation Department of Health, Hwy 264 and St. Michael Road, St Michael, AZ, 86511, USA.
Clarina ClarkCommunity Outreach and Patient Empowerment (COPE), 210 East Aztec Avenue, Gallup, NM, 87301, USA.
Judy SingerCommunity Outreach and Patient Empowerment (COPE), 210 East Aztec Avenue, Gallup, NM, 87301, USA.
Sonya ShinDivision of Global Health Equity, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA.
Adrianne Katrina NelsonDepartment of Global Community Health and Behavioral Sciences, Tulane School of Public Health and Tropical Medicine, 1440 Canal Street, New Orleans, LA, 70112, USA. adrianne.katrina.nelson@gmail.com.ORCID http://orcid.org/0000-0001-5351-2761
Brigham and Women's Hospital · USEmpowerment Program · USNavajo Nation Division of Health · USNorthwestern University · USTulane University · USUniversity of New Mexico · US

Funding

Patient-Centered Outcomes Research Institute AD1304-6566
6 · The paper itself

Abstract

backgroundCommunity Health Representatives (CHRs) overcome health disparities in Native communities by delivering home care, health education, and community health promotion. The Navajo CHR Program partners with the non-profit Community Outreach and Patient Empowerment (COPE), to provide home-based outreach to Navajo clients living with diabetes. COPE has created an intervention (COPE intervention) focusing on multiple levels of improved care including trainings for CHRs on Motivational Interviewing and providing CHRs with culturally-appropriate education materials. The objective of this research is to understand the participant perspective of the CHR-COPE collaborative outreach through exploring patient-reported outcomes (PROs) of clients who consent to receiving the COPE intervention (COPE clients) using a qualitative methods evaluation.

methodsSeven COPE clients were selected to participate in semi-structured interviews one year after finishing COPE to explore their perspective and experiences. Qualitative interviews were recorded, transcribed, and coded to identify themes.

resultsClients revealed that health education delivered by CHRs facilitated lifestyle changes by helping them understand key health indicators and setting achievable goals through the use of accessible material and encouragement. Clients felt comfortable with CHRs who respected traditional practices and made regular visits. Clients also appreciated when CHRs educated their family members, who in turn were better able to support the client in their health management. Finally, CHRs who implemented the COPE intervention helped patients who were unable to regularly see a primary care doctor for critical care and support in their disease management.

conclusionThe COPE-CHR collaboration facilitated trusting client-CHR relationships and allowed clients to better understand their diagnoses. Further investment in materials that respect traditional practices and aim to educate clients' families may foster these relationships and improve health outcomes.

trial registrationclinicaltrials.gov: NCT03326206. Registered 9/26/2017 (retrospectively registered).

Indexed as

Alaska NativesAttitude to HealthCommunity Health ServicesCommunity Health WorkersCommunity-Institutional RelationsCooperative BehaviorDiabetes MellitusFemaleHumansIndians, North AmericanMaleMiddle AgedOrganizations, NonprofitPatient ParticipationProfessional-Patient RelationsProgram EvaluationAlaskan nativesAmerican IndiansCommunity health representativeCommunity health workerDiabetesHealth equityNavajoPatient-reported outcomesQualitative

Identifiers

PMID31914997
PMCPMC6950858
OpenAlexW3000476015

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.