Assessing the impact of community-based interventions on hypertension and diabetes management in three Minnesota communities: Findings from the prospective evaluation of US HealthRise programs

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Creator
  • Fullman N.
    • Other Affiliation: University of Washington
  • Cowling K.
    • Other Affiliation: US Department of Health and Human Services
  • Flor L.S.
    • Other Affiliation: University of Washington
  • Wilson S.
    • Other Affiliation: University of Washington
  • Bhatt P.
    • Other Affiliation: Medtronic Foundation
  • Bryant M.F.
    • Other Affiliation: University of Washington
  • Camarda J.N.
    • Other Affiliation: University of Washington
  • Colombara D.V.
    • Other Affiliation: Public Health Seattle
  • Daly J.
    • Other Affiliation: Medtronic Foundation
  • Gabert R.K.
    • Other Affiliation: University of Washington
  • Harris K.P.
    • Other Affiliation: University of Washington
  • Johanns C.K.
    • Other Affiliation: University of Washington
  • Mandile C.
    • Other Affiliation: HealthFinders Collaborative
  • Marshall S.
    • Other Affiliation: International School of Djibouti
  • McNellan C.R.
    • Affiliation: School of Social Work
  • Mulakaluri V.
    • Other Affiliation: University of Washington
  • Phillips B.K.
    • Other Affiliation: The Permanente Medical Group
  • Reitsma M.B.
    • Other Affiliation: University of Washington
  • Sadighi N.
    • Other Affiliation: Small Sums
  • Tamene T.
    • Other Affiliation: Pillsbury United Communities
  • Thomson B.
    • Other Affiliation: American Cancer Society
  • Wollum A.
    • Other Affiliation: Ibis Reproductive Health
  • Gakidou E.
    • Other Affiliation: University of Washington
Abstract
  • Background Community-based health interventions are increasingly viewed as models of care that can bridge healthcare gaps experienced by underserved communities in the United States (US). With this study, we sought to assess the impact of such interventions, as implemented through the US HealthRise program, on hypertension and diabetes among underserved communities in Hennepin, Ramsey, and Rice Counties, Minnesota. Methods and findings HealthRise patient data from June 2016 to October 2018 were assessed relative to comparison patients in a difference-in-difference analysis, quantifying program impact on reducing systolic blood pressure (SBP) and hemoglobin A1c, as well as meeting clinical targets (< 140 mmHg for hypertension, < 8% Al1c for diabetes), beyond routine care. For hypertension, HealthRise participation was associated with SBP reductions in Rice (6.9 mmHg [95% confidence interval: 0.9–12.9]) and higher clinical target achievement in Hennepin (27.3 percentage-points [9.8–44.9]) and Rice (17.1 percentage-points [0.9 to 33.3]). For diabetes, HealthRise was associated with A1c decreases in Ramsey (1.3 [0.4–2.2]). Qualitative data showed the value of home visits alongside clinic-based services; however, challenges remained, including community health worker retention and program sustainability. Conclusions HealthRise participation had positive effects on improving hypertension and diabetes outcomes at some sites. While community-based health programs can help bridge healthcare gaps, they alone cannot fully address structural inequalities experienced by many underserved communities.
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Resource type
  • Article
License
  • CC0 1.0 Universal
Journal title
  • PLoS ONE
Journal volume
  • 18
Journal issue
  • 2-Feb
Language
  • English
Version
  • Publisher
Funder
  • HealthFinders Collaborative Inc.
  • Medtronic Foundation, MF
  • Regions Hospital Foundation
  • Institute for Health Metrics and Evaluation, IHME
ISSN
  • 1932-6203
Publisher
  • Public Library of Science

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