Community Health Workers, Access to Care, and Service Utilization Among Florida Latinos: A Randomized Controlled Trial

Am J Public Health. 2018 Sep;108(9):1249-1251. doi: 10.2105/AJPH.2018.304542. Epub 2018 Jul 19.


Objectives: To determine whether a 1-year community health worker intervention improves access to care and service utilization among Latinos with diabetes.

Methods: We conducted a single-blind randomized trial of 300 adults with poorly controlled diabetes treated in 2 public hospital clinics in Miami, Florida. We began enrollment in 2010 and completed follow-up in 2015. We examined access and utilization using self-reported measures and data from electronic medical records.

Results: Participants randomized to the community health worker intervention self-reported fewer problems accessing needed care and prescriptions than did those in the usual care group (30% vs 43% and 28% vs 41%, respectively; P < .05 for both). Adjusting for age, gender, education, depression, and comorbidities showed similar results (odds ratio [OR] = 0.52; 95% confidence interval [CI] = 0.29, 0.93 and OR = 0.45; CI = 0.24, 0.82, respectively). We found no significant utilization differences in primary care visits, emergency department utilization, or hospitalization between the 2 groups.

Conclusions: Among Latinos with poorly controlled diabetes, a 1-year community health worker intervention was associated with improvements in self-reported access to care but not service utilization.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Community Health Workers*
  • Electronic Health Records
  • Emergency Service, Hospital
  • Female
  • Florida
  • Health Services Accessibility*
  • Hispanic or Latino*
  • Humans
  • Male
  • Middle Aged
  • Primary Health Care
  • Self Report
  • Single-Blind Method
  • Urban Population