The Baltimore Community-Based Organizations Neighborhood Network: Enhancing Capacity Together (CONNECT) Cluster RCT.
Baltimore
Community Health Services
/ statistics & numerical data
Emergency Service, Hospital
/ statistics & numerical data
Female
Hospitalization
/ statistics & numerical data
Humans
Internet
Male
Middle Aged
Patient Acceptance of Health Care
/ statistics & numerical data
Personnel, Hospital
Referral and Consultation
Residence Characteristics
Social Determinants of Health
Surveys and Questionnaires
Journal
American journal of preventive medicine
ISSN: 1873-2607
Titre abrégé: Am J Prev Med
Pays: Netherlands
ID NLM: 8704773
Informations de publication
Date de publication:
08 2019
08 2019
Historique:
received:
26
07
2018
revised:
11
03
2019
accepted:
12
03
2019
pubmed:
30
6
2019
medline:
6
8
2020
entrez:
29
6
2019
Statut:
ppublish
Résumé
This cluster RCT aimed to reduce healthcare utilization and increase the referral of patients between an academic health center and local community-based organizations (CBOs) that address social determinants of health. Cluster RCT. Twenty-two CBOs located in Baltimore, Maryland, were randomly assigned to the intervention or control group, and 5,255 patients were allocated to the intervention or control group based on whether they lived closer to an intervention or control CBO. Data were collected in 2014-2016; the analysis was conducted in 2016. A multicomponent intervention included an online tool to help refer clients to community resources, meet-and-greet sessions between CBO staff and healthcare staff, and research assistants. The primary outcomes were patient emergency department visits and days spent in the hospital. Additional outcomes for CBO clients included knowledge of other CBOs, number of referrals to CBOs by the healthcare system, and number of referrals to healthcare system by CBOs. Outcomes for CBO staff included the number of referrals made to and received from the healthcare system and the number of referrals made to and received from other CBOs. There was no significant effect of the intervention on healthcare utilization outcomes, CBO client outcomes, or CBO staff outcomes. Ancillary analyses demonstrated a 2.9% increase in referrals by inpatient staff to intervention CBOs (p=0.051) and a 6.6% increase in referrals by outpatient staff to intervention CBOs between baseline and follow-up (p=0.027). Outpatient staff reported a significant reduction in barriers related to the lack of information about CBO services (-18.3%, p=0.004) and an increase in confidence in community resources (+14.4%, p=0.023) from baseline to follow-up. The intervention did not improve healthcare utilization outcomes but was associated with increased healthcare staff knowledge of, and confidence in, local CBOs. This study is registered at www.clinicaltrials.gov NCT02222909.
Identifiants
pubmed: 31248746
pii: S0749-3797(19)30163-1
doi: 10.1016/j.amepre.2019.03.013
pii:
doi:
Banques de données
ClinicalTrials.gov
['NCT02222909']
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e31-e41Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2019 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.