Strategies to improve chronic disease management in seven metro Boston community health centers

Prog Community Health Partnersh. Fall 2009;3(3):203-11. doi: 10.1353/cpr.0.0080.

Abstract

Background: The Community, Health Center, and Academic Medicine Partnership Project (CHAMPP) is a partnership between medical researchers, community health centers (CHCs), and a community advisory committee focused on reducing cardiovascular morbidity related to hypertension and diabetes for non-Hispanic Black and Hispanic populations in Boston, Massachusetts.

Objective: We conducted site visits at seven participating CHCs, located in Boston. The visits were to solicit health center staff opinions about site-specific barriers and enabling factors for optimum preventative cardiovascular care for racial/ethnic minority patients receiving hypertension and diabetes care at their centers.

Methods: Site visits included a tour of each health center and a series of directed interviews with center personnel. Site visit notes were reviewed to identify themes that emerged during the course of each site visit. A summary matrix was developed for each health center, which included information regarding the most salient and persistent themes of the visit.

Results: Site visits uncovered several patient-, provider-, CHC-, and community-based factors that either facilitate or hinder optimal care of chronic disease patients. Commonly referenced barriers included the need for improved patient adherence to provider recommendations; insufficient time for providers to address complex health issues presented by patients and the need for a broader range of healthier food options in surrounding communities. Interactive patient groups and community health workers (CHWs) have been well received when implemented.

Conclusion: Recommendations included adopting case management as a part of usual care for chronic disease patients; additionally, widespread implementation of CHWs may to provide a platform for more comprehensive care for patients.

Trial registration: ClinicalTrials.gov NCT00379652.

Keywords: Community-based participatory research; cardiovascular diseases; diabetes mellitus; endocrine system diseases; health disparities; health outcomes.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Boston
  • Cardiovascular Diseases / drug therapy
  • Cardiovascular Diseases / prevention & control
  • Case Management
  • Chronic Disease
  • Community Health Centers / organization & administration*
  • Community Networks / organization & administration*
  • Community-Based Participatory Research
  • Cooperative Behavior*
  • Diabetes Mellitus / drug therapy
  • Diabetes Mellitus / prevention & control
  • Disease Management*
  • Endocrine System Diseases / drug therapy
  • Endocrine System Diseases / prevention & control
  • Health Promotion*
  • Health Status Disparities
  • Humans
  • Massachusetts

Associated data

  • ClinicalTrials.gov/NCT00379652