Community Health Worker Intervention to Improve Post-Hospital Outcomes

NCT ID: NCT04028609

Last Updated: 2023-04-28

Basic Information

• Recruitment Status: TERMINATED
• Clinical Phase: NA
• Total Enrollment: 55 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2019-09-12
• Study Completion Date: 2020-03-09

Brief Summary

This study tests an intervention designed to avoid 30-day readmissions following a medical hospitalization by patients who have co-occurring mental illness. The Intervention is delivered by community health workers in the inpatient setting and 30 days following hospital discharge to the community.

Detailed Description

This study will test the efficacy of a brief intervention delivered to adults with co-occurring medical and mental health conditions by community health workers designed to avoid 30-day readmissions following medical hospitalization. Adult inpatients of a university hospital will be randomly assigned to the intervention plus services as usual versus services as usual alone, and assessed at baseline and 30 days following discharge. Chi square will be used to assess the primary outcome of admission within 30 days of discharge and changes in patient activation, mental health symptoms, medication adherence, and perceived competence for health maintenance. Also examined will be study condition differences in post-discharge inpatient service utilization and cost.

Conditions

Chronic Disease (Physical); Mental Disorder

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: SINGLE

Study Groups

Intervention

Subjects receive an intervention with 4 components: development of a personal health plan; review and support for medication adherence; connection with primary care provider within 30 days; and education about clinical indicators that call for immediate intervention.

Group Type: EXPERIMENTAL

Healthy at Home

Intervention Type: BEHAVIORAL

In addition to receiving medical services as usual, subjects receive services from Community Healthy Workers during the transition from the hospital to their community residence.

Services as Usual

Subjects receive medical services as usual.

Group Type: ACTIVE_COMPARATOR

Services as Usual

Intervention Type: OTHER

Routine medical services

Interventions

Healthy at Home

In addition to receiving medical services as usual, subjects receive services from Community Healthy Workers during the transition from the hospital to their community residence.

Intervention Type: BEHAVIORAL

Services as Usual

Routine medical services

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• receiving inpatient treatment for chronic medical condition
• evidence of a mental health diagnosis
• age 21- 60 years
• expected to return to community residence
• residing within a 30-mile radius of the hospital
• expected to remain in hospital for 2 or more days
• able to provide informed consent

Exclusion Criteria

• terminally ill
• unable to communicate in English
• expected to be discharged to skilled facility or nursing home
• participating in another transitional care intervention
• hospitalized for behavioral health disorder

• Minimum Eligible Age: 21 Years
• Maximum Eligible Age: 60 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

National Institute on Disability, Independent Living, and Rehabilitation Research

FED

Sponsor Role: collaborator

Substance Abuse and Mental Health Services Administration (SAMHSA)

FED

Sponsor Role: collaborator

University of Illinois at Chicago

OTHER

Sponsor Role: lead

Responsible Party

Judith A. Cook

Professor of Psychiatry

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Judith Cook, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Illinois at Chicago

Locations

University of Illinois at Chicago, Department of Psychiatry

Chicago, Illinois, United States

Countries

United States

References

Cook JA, Mueser KT. Community health workers: Potential allies for the field of psychiatric rehabilitation? Psychiatr Rehabil J. 2015 Sep;38(3):207-9. doi: 10.1037/prj0000164.

Reference Type: BACKGROUND

PMID: 26348316 (View on PubMed)

Other Identifiers

90RT5038a

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

2018-0715

Identifier Type: -

Identifier Source: org_study_id