Table 1.
Patient-Reported Outcomes Among Rural Patients Engaged in CHW Model (n = 28)
| Baseline mean (SD) | 12 months mean (SD) | Change mean (SD) | p value | |
| Self-management behaviors | ||||
| Days per week with healthful eating | 4.3 (2.2) | 4.2 (2.4) | − 0.1 (2.5) | 0.880 |
| Days per week with fruits and vegetables | 4.4 (1.9) | 4.8 (2.1) | 0.4 (2.3) | 0.367 |
| Days per week with high-fat foods | 3.6 (1.8) | 3.7 (2.0) | 0.1 (2.4) | 0.752 |
| Days per week of meeting exercise | 3.7 (2.5) | 4.4 (2.3) | 0.7 (3.2) | 0.270 |
| Days per week testing blood sugar | 6.8 (1.0) | 6.8 (1.1) | 0.0 (1.5) | 1.000 |
| Days per week testing blood sugar per provider recommendations | 6.8 (0.8) | 6.5 (1.6) | − 0.3 (1.5) | 0.302 |
| Days per week taking meds as prescribed | 6.9 (0.8) | 7.0 (0) | 0.1 (0.8) | 0.326 |
| Days per week checking feet | 5.6 (2.3) | 6.1 (1.8) | 0.6 (2.6) | 0.263 |
| Sugar-sweetened beverages per day | 0.9 (1.2) | 0.7 (1.1) | − 0.2 (1.4) | 0.407 |
| Self-efficacy | ||||
| Confidence in choosing healthy foods | 6.3 (2.7) | 7.3 (2.1)† | 0.9 (2.7) | 0.075 |
| Confidence in exercising | 6.0 (3.3) | 7.0 (3.2) | 1.0 (3.5) | 0.144 |
| Confidence when blood sugar goes high or low | 7.9 (2.5) | 9.2 (1.3)* | 1.3 (2.7) | 0.017 |
| Confidence in diabetes not interfering | 6.4 (2.5) | 8.2 (1.8)* | 1.8 (3.1) | 0.005 |
| Quality of life | ||||
| Days of the last 30 when physical health is not good | 13.1 (10.7) | 10.0 (10.9) | − 3.0 (13.6) | 0.249 |
| Days of the last 30 when mental health is not good | 9.3 (11.0) | 6.4 (8.2) | − 3.0 (11.6) | 0.187 |
| Days of the last 30 when physical or mental health impacts life | 11.2 (12.7) | 8.9 (11.1) | − 2.3 (15.4) | 0.467 |
| Days of the last 30 when pain makes it hard for usual activities | 7.8 (12.1) | 7.1 (10.7) | − 0.7 (16.1) | 0.817 |
| n (%) | n (%) | p value | ||
| Self-rated health (e.g., good, very good, excellent) | 14 (50) | 14 (50) | – | 0.732 |
| Same health, or better, as 6 months ago | 22 (79) | 21 (75) | – | 0.120 |
| Limited by health | 17 (61) | 15 (54) | – | 0.773 |
| Patient experience | ||||
| PCP discusses work or life (e.g., always, usually) | 21 (75) | 23 (82) | – | 0.139 |
| PCP asks your ideas about your care (e.g., always, usually) | 18 (64) | 21 (75) | – | 0.179 |
Note: Paired t tests, McNemar’s tests, and Wilcoxon signed-rank tests were used to evaluate differences between patient-reported outcomes at baseline and 12 months. Change values in italics represent improvements from baseline across patients; values in bold represent worsening outcomes from baseline across patients. Full survey is available as an appendix in Wang G, Gauthier R, Gunter KE, et al. Improving diabetes care through population health innovations and payments: lessons from Western Maryland. In preparation for Journal of General Internal Medicine Supplement; 2022
CHW community health worker, PCP primary care provider
*Denotes significant improvement from baseline (p < 0.05)
†Denotes trend in improvement from baseline (p < 0.10)