The Experts below are selected from a list of 263829 Experts worldwide ranked by ideXlab platform
David M Levine - One of the best experts on this subject based on the ideXlab platform.
-
Community outreach and cardiovascular health coach trial a randomized controlled trial of nurse practitioner Community health worker cardiovascular disease risk reduction in Urban Community health centers
Circulation-cardiovascular Quality and Outcomes, 2011Co-Authors: Jerilyn K Allen, Lee R Bone, Martha N Hill, David M Levine, Cheryl Dennisonhimmelfarb, Sarah L Szanton, Murray West, Amy Barlow, Lapricia Lewisboyer, Mary DonnellystrozzoAbstract:Background—Despite well-publicized guidelines on the appropriate management of cardiovascular disease and type 2 diabetes, the implementation of risk-reducing practices remains poor. This report describes the results of a randomized, controlled clinical trial evaluating the effectiveness of a comprehensive program of cardiovascular disease risk reduction delivered by nurse practitioner /Community health worker (NP/CHW) teams versus enhanced usual care (EUC) to improve lipids, blood pressure, glycated hemoglobin (HbA1c), and patient perceptions of the quality of their chronic illness care in patients in Urban Community health centers. Methods and Results—A total of 525 patients with documented cardiovascular disease, type 2 diabetes, hypercholesterolemia, or hypertension and levels of LDL cholesterol, blood pressure, or HbA1c that exceeded goals established by national guidelines were randomly assigned to NP/CHW (n=261) or EUC (n=264) groups. The NP/CHW intervention included aggressive pharmacological mana...
-
Community outreach and cardiovascular health coach trial a randomized controlled trial of nurse practitioner Community health worker cardiovascular disease risk reduction in Urban Community health centers
Circulation-cardiovascular Quality and Outcomes, 2011Co-Authors: Jerilyn K Allen, Lee R Bone, Martha N Hill, David M Levine, Cheryl Dennisonhimmelfarb, Sarah L Szanton, Murray West, Amy Barlow, Lapricia Lewisboyer, Mary DonnellystrozzoAbstract:Background— Despite well-publicized guidelines on the appropriate management of cardiovascular disease and type 2 diabetes, the implementation of risk-reducing practices remains poor. This report describes the results of a randomized, controlled clinical trial evaluating the effectiveness of a comprehensive program of cardiovascular disease risk reduction delivered by nurse practitioner /Community health worker (NP/CHW) teams versus enhanced usual care (EUC) to improve lipids, blood pressure, glycated hemoglobin (HbA1c), and patient perceptions of the quality of their chronic illness care in patients in Urban Community health centers. Methods and Results— A total of 525 patients with documented cardiovascular disease, type 2 diabetes, hypercholesterolemia, or hypertension and levels of LDL cholesterol, blood pressure, or HbA1c that exceeded goals established by national guidelines were randomly assigned to NP/CHW (n=261) or EUC (n=264) groups. The NP/CHW intervention included aggressive pharmacological management and tailored educational and behavioral counseling for lifestyle modification and problem solving to address barriers to adherence and control. Compared with EUC, patients in the NP/CHW group had significantly greater 12-month improvement in total cholesterol (difference, 19.7 mg/dL), LDL cholesterol (difference,15.9 mg/dL), triglycerides (difference, 16.3 mg/dL), systolic blood pressure (difference, 6.2 mm Hg), diastolic blood pressure (difference, 3.1 mm Hg), HbA1c (difference, 0.5%), and perceptions of the quality of their chronic illness care (difference, 1.2 points). Conclusions— An intervention delivered by an NP/CHW team using individualized treatment regimens based on treat-to-target algorithms can be an effective approach to improve risk factor status and perceptions of chronic illness care in high-risk patients. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT00241904.
-
coach trial a randomized controlled trial of nurse practitioner Community health worker cardiovascular disease risk reduction in Urban Community health centers rationale and design
Contemporary Clinical Trials, 2011Co-Authors: Lee R Bone, Martha N Hill, David M Levine, Jerilyn K Allen, Sarah L Szanton, Cheryl Dennison HimmelfarbAbstract:Abstract Background Despite well-publicized guidelines on the appropriate management of cardiovascular disease (CVD) and type 2 diabetes, implementation of risk-reducing practices remains poor. This paper describes the rationale and design of a randomized controlled clinical trial evaluating the effectiveness of a comprehensive program of CVD risk reduction delivered by nurse practitioner (NP)/Community health worker (CHW) teams versus enhanced usual care in improving the proportion of patients in Urban Community health centers who achieve goal levels recommended by national guidelines for lipids, blood pressure, HbA1c and prescription of appropriate medications. Methods The COACH (Community Outreach and Cardiovascular Health) trial is a randomized controlled trial in which patients at federally-qualified Community health centers were randomly assigned to one of two groups: comprehensive intensive management of CVD risk factors for one year by a NP/CHW team or an enhanced usual care control group. Results A total of 3899 patients were assessed for eligibility and 525 were randomized. Groups were comparable at baseline on sociodemographic and clinical characteristics with the exception of statistically significant differences in total cholesterol and hemoglobin A1c. Conclusions This study is a novel amalgam of multilevel interdisciplinary strategies to translate highly efficacious therapies to low-income federally-funded health centers that care for patients who carry a disproportionate burden of CVD, type 2 diabetes and uncontrolled CVD risk factors. The impact of such a Community clinic-based intervention is potentially enormous.
Matthew J Mimiaga - One of the best experts on this subject based on the ideXlab platform.
-
laboratory confirmed hiv and sexually transmitted infection seropositivity and risk behavior among sexually active transgender patients at an adolescent and young adult Urban Community health center
Aids Care-psychological and Socio-medical Aspects of Aids\ hiv, 2015Co-Authors: Sari L Reisner, Ralph Vetters, Jaclyn M White, Elijah L Cohen, M Leclerc, Shayne Zaslow, Sarah Wolfrum, Matthew J MimiagaAbstract:The sexual health of transgender adolescents and young adults who present for health care in Urban Community health centers is understudied. A retrospective review of electronic health record (EHR) data was conducted from 180 transgender patients aged 12–29 years seen for one or more health-care visits between 2001 and 2010 at an Urban Community health center serving youth in Boston, MA. Analyses were restricted to 145 sexually active transgender youth (87.3% of the sample). Laboratory-confirmed HIV and sexually transmitted infections (STIs) seroprevalence, demographics, sexual risk behavior, and structural and psychosocial risk indicators were extracted from the EHR. Analyses were descriptively focused for HIV and STIs. Stratified multivariable logistic regression models were fit for male-to-female (MTF) and female-to-male (FTM) patients separately to examine factors associated with any unprotected anal and/or vaginal sex (UAVS). The mean age was 20.0 (SD = 2.9); 21.7% people of color, 46.9% white (non-H...
-
laboratory confirmed hiv and sexually transmitted infection seropositivity and risk behavior among sexually active transgender patients at an adolescent and young adult Urban Community health center
Aids Care-psychological and Socio-medical Aspects of Aids\ hiv, 2015Co-Authors: Sari L Reisner, Ralph Vetters, Jaclyn M White, Elijah L Cohen, M Leclerc, Shayne Zaslow, Sarah Wolfrum, Matthew J MimiagaAbstract:The sexual health of transgender adolescents and young adults who present for health care in Urban Community health centers is understudied. A retrospective review of electronic health record (EHR) data was conducted from 180 transgender patients aged 12-29 years seen for one or more health-care visits between 2001 and 2010 at an Urban Community health center serving youth in Boston, MA. Analyses were restricted to 145 sexually active transgender youth (87.3% of the sample). Laboratory-confirmed HIV and sexually transmitted infections (STIs) seroprevalence, demographics, sexual risk behavior, and structural and psychosocial risk indicators were extracted from the EHR. Analyses were descriptively focused for HIV and STIs. Stratified multivariable logistic regression models were fit for male-to-female (MTF) and female-to-male (FTM) patients separately to examine factors associated with any unprotected anal and/or vaginal sex (UAVS). The mean age was 20.0 (SD=2.9); 21.7% people of color, 46.9% white (non-Hispanic), 21.4% race/ethnicity unknown; 43.4% MTF, and 56.6% FTM; and 68.3% were on cross-sex hormones. Prevalence of STIs: 4.8% HIV, 2.8% herpes simplex virus, 2.8% syphilis, 2.1% chlamydia, 2.1% gonorrhea, 2.8% hepatitis C, 1.4% human papilloma virus. Only gonorrhea prevalence significantly differed by gender identity (MTF 2.1% vs. 0.0% FTM; p=0.046). Nearly half (47.6%) of the sample engaged in UAVS (52.4% MTF, 43.9% FTM, p=0.311). FTM more frequently had a primary sex partner compared to MTF (48.8% vs. 25.4%; p=0.004); MTF more frequently had a casual sex partner than FTM (69.8% vs. 42.7% p=0.001). In multivariable models, MTF youth who were younger in age, white non-Hispanic, and reported a primary sex partner had increased odds of UAVS; whereas, FTM youth reporting a casual sex partner and current alcohol use had increased odds of UAVS (all p<0.05). Factors associated with sexual risk differ for MTF and FTM youth. Partner type appears pivotal to understanding sexual risk in transgender adolescents and young adults. HIV and STI prevention efforts, including early intervention efforts, are needed in Community-based settings serving transgender youth that attend to sex-specific (biological) and gender-related (social) pathways.
Jerilyn K Allen - One of the best experts on this subject based on the ideXlab platform.
-
Community outreach and cardiovascular health coach trial a randomized controlled trial of nurse practitioner Community health worker cardiovascular disease risk reduction in Urban Community health centers
Circulation-cardiovascular Quality and Outcomes, 2011Co-Authors: Jerilyn K Allen, Lee R Bone, Martha N Hill, David M Levine, Cheryl Dennisonhimmelfarb, Sarah L Szanton, Murray West, Amy Barlow, Lapricia Lewisboyer, Mary DonnellystrozzoAbstract:Background—Despite well-publicized guidelines on the appropriate management of cardiovascular disease and type 2 diabetes, the implementation of risk-reducing practices remains poor. This report describes the results of a randomized, controlled clinical trial evaluating the effectiveness of a comprehensive program of cardiovascular disease risk reduction delivered by nurse practitioner /Community health worker (NP/CHW) teams versus enhanced usual care (EUC) to improve lipids, blood pressure, glycated hemoglobin (HbA1c), and patient perceptions of the quality of their chronic illness care in patients in Urban Community health centers. Methods and Results—A total of 525 patients with documented cardiovascular disease, type 2 diabetes, hypercholesterolemia, or hypertension and levels of LDL cholesterol, blood pressure, or HbA1c that exceeded goals established by national guidelines were randomly assigned to NP/CHW (n=261) or EUC (n=264) groups. The NP/CHW intervention included aggressive pharmacological mana...
-
Community outreach and cardiovascular health coach trial a randomized controlled trial of nurse practitioner Community health worker cardiovascular disease risk reduction in Urban Community health centers
Circulation-cardiovascular Quality and Outcomes, 2011Co-Authors: Jerilyn K Allen, Lee R Bone, Martha N Hill, David M Levine, Cheryl Dennisonhimmelfarb, Sarah L Szanton, Murray West, Amy Barlow, Lapricia Lewisboyer, Mary DonnellystrozzoAbstract:Background— Despite well-publicized guidelines on the appropriate management of cardiovascular disease and type 2 diabetes, the implementation of risk-reducing practices remains poor. This report describes the results of a randomized, controlled clinical trial evaluating the effectiveness of a comprehensive program of cardiovascular disease risk reduction delivered by nurse practitioner /Community health worker (NP/CHW) teams versus enhanced usual care (EUC) to improve lipids, blood pressure, glycated hemoglobin (HbA1c), and patient perceptions of the quality of their chronic illness care in patients in Urban Community health centers. Methods and Results— A total of 525 patients with documented cardiovascular disease, type 2 diabetes, hypercholesterolemia, or hypertension and levels of LDL cholesterol, blood pressure, or HbA1c that exceeded goals established by national guidelines were randomly assigned to NP/CHW (n=261) or EUC (n=264) groups. The NP/CHW intervention included aggressive pharmacological management and tailored educational and behavioral counseling for lifestyle modification and problem solving to address barriers to adherence and control. Compared with EUC, patients in the NP/CHW group had significantly greater 12-month improvement in total cholesterol (difference, 19.7 mg/dL), LDL cholesterol (difference,15.9 mg/dL), triglycerides (difference, 16.3 mg/dL), systolic blood pressure (difference, 6.2 mm Hg), diastolic blood pressure (difference, 3.1 mm Hg), HbA1c (difference, 0.5%), and perceptions of the quality of their chronic illness care (difference, 1.2 points). Conclusions— An intervention delivered by an NP/CHW team using individualized treatment regimens based on treat-to-target algorithms can be an effective approach to improve risk factor status and perceptions of chronic illness care in high-risk patients. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT00241904.
-
coach trial a randomized controlled trial of nurse practitioner Community health worker cardiovascular disease risk reduction in Urban Community health centers rationale and design
Contemporary Clinical Trials, 2011Co-Authors: Lee R Bone, Martha N Hill, David M Levine, Jerilyn K Allen, Sarah L Szanton, Cheryl Dennison HimmelfarbAbstract:Abstract Background Despite well-publicized guidelines on the appropriate management of cardiovascular disease (CVD) and type 2 diabetes, implementation of risk-reducing practices remains poor. This paper describes the rationale and design of a randomized controlled clinical trial evaluating the effectiveness of a comprehensive program of CVD risk reduction delivered by nurse practitioner (NP)/Community health worker (CHW) teams versus enhanced usual care in improving the proportion of patients in Urban Community health centers who achieve goal levels recommended by national guidelines for lipids, blood pressure, HbA1c and prescription of appropriate medications. Methods The COACH (Community Outreach and Cardiovascular Health) trial is a randomized controlled trial in which patients at federally-qualified Community health centers were randomly assigned to one of two groups: comprehensive intensive management of CVD risk factors for one year by a NP/CHW team or an enhanced usual care control group. Results A total of 3899 patients were assessed for eligibility and 525 were randomized. Groups were comparable at baseline on sociodemographic and clinical characteristics with the exception of statistically significant differences in total cholesterol and hemoglobin A1c. Conclusions This study is a novel amalgam of multilevel interdisciplinary strategies to translate highly efficacious therapies to low-income federally-funded health centers that care for patients who carry a disproportionate burden of CVD, type 2 diabetes and uncontrolled CVD risk factors. The impact of such a Community clinic-based intervention is potentially enormous.
Martha N Hill - One of the best experts on this subject based on the ideXlab platform.
-
Community outreach and cardiovascular health coach trial a randomized controlled trial of nurse practitioner Community health worker cardiovascular disease risk reduction in Urban Community health centers
Circulation-cardiovascular Quality and Outcomes, 2011Co-Authors: Jerilyn K Allen, Lee R Bone, Martha N Hill, David M Levine, Cheryl Dennisonhimmelfarb, Sarah L Szanton, Murray West, Amy Barlow, Lapricia Lewisboyer, Mary DonnellystrozzoAbstract:Background—Despite well-publicized guidelines on the appropriate management of cardiovascular disease and type 2 diabetes, the implementation of risk-reducing practices remains poor. This report describes the results of a randomized, controlled clinical trial evaluating the effectiveness of a comprehensive program of cardiovascular disease risk reduction delivered by nurse practitioner /Community health worker (NP/CHW) teams versus enhanced usual care (EUC) to improve lipids, blood pressure, glycated hemoglobin (HbA1c), and patient perceptions of the quality of their chronic illness care in patients in Urban Community health centers. Methods and Results—A total of 525 patients with documented cardiovascular disease, type 2 diabetes, hypercholesterolemia, or hypertension and levels of LDL cholesterol, blood pressure, or HbA1c that exceeded goals established by national guidelines were randomly assigned to NP/CHW (n=261) or EUC (n=264) groups. The NP/CHW intervention included aggressive pharmacological mana...
-
Community outreach and cardiovascular health coach trial a randomized controlled trial of nurse practitioner Community health worker cardiovascular disease risk reduction in Urban Community health centers
Circulation-cardiovascular Quality and Outcomes, 2011Co-Authors: Jerilyn K Allen, Lee R Bone, Martha N Hill, David M Levine, Cheryl Dennisonhimmelfarb, Sarah L Szanton, Murray West, Amy Barlow, Lapricia Lewisboyer, Mary DonnellystrozzoAbstract:Background— Despite well-publicized guidelines on the appropriate management of cardiovascular disease and type 2 diabetes, the implementation of risk-reducing practices remains poor. This report describes the results of a randomized, controlled clinical trial evaluating the effectiveness of a comprehensive program of cardiovascular disease risk reduction delivered by nurse practitioner /Community health worker (NP/CHW) teams versus enhanced usual care (EUC) to improve lipids, blood pressure, glycated hemoglobin (HbA1c), and patient perceptions of the quality of their chronic illness care in patients in Urban Community health centers. Methods and Results— A total of 525 patients with documented cardiovascular disease, type 2 diabetes, hypercholesterolemia, or hypertension and levels of LDL cholesterol, blood pressure, or HbA1c that exceeded goals established by national guidelines were randomly assigned to NP/CHW (n=261) or EUC (n=264) groups. The NP/CHW intervention included aggressive pharmacological management and tailored educational and behavioral counseling for lifestyle modification and problem solving to address barriers to adherence and control. Compared with EUC, patients in the NP/CHW group had significantly greater 12-month improvement in total cholesterol (difference, 19.7 mg/dL), LDL cholesterol (difference,15.9 mg/dL), triglycerides (difference, 16.3 mg/dL), systolic blood pressure (difference, 6.2 mm Hg), diastolic blood pressure (difference, 3.1 mm Hg), HbA1c (difference, 0.5%), and perceptions of the quality of their chronic illness care (difference, 1.2 points). Conclusions— An intervention delivered by an NP/CHW team using individualized treatment regimens based on treat-to-target algorithms can be an effective approach to improve risk factor status and perceptions of chronic illness care in high-risk patients. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT00241904.
-
coach trial a randomized controlled trial of nurse practitioner Community health worker cardiovascular disease risk reduction in Urban Community health centers rationale and design
Contemporary Clinical Trials, 2011Co-Authors: Lee R Bone, Martha N Hill, David M Levine, Jerilyn K Allen, Sarah L Szanton, Cheryl Dennison HimmelfarbAbstract:Abstract Background Despite well-publicized guidelines on the appropriate management of cardiovascular disease (CVD) and type 2 diabetes, implementation of risk-reducing practices remains poor. This paper describes the rationale and design of a randomized controlled clinical trial evaluating the effectiveness of a comprehensive program of CVD risk reduction delivered by nurse practitioner (NP)/Community health worker (CHW) teams versus enhanced usual care in improving the proportion of patients in Urban Community health centers who achieve goal levels recommended by national guidelines for lipids, blood pressure, HbA1c and prescription of appropriate medications. Methods The COACH (Community Outreach and Cardiovascular Health) trial is a randomized controlled trial in which patients at federally-qualified Community health centers were randomly assigned to one of two groups: comprehensive intensive management of CVD risk factors for one year by a NP/CHW team or an enhanced usual care control group. Results A total of 3899 patients were assessed for eligibility and 525 were randomized. Groups were comparable at baseline on sociodemographic and clinical characteristics with the exception of statistically significant differences in total cholesterol and hemoglobin A1c. Conclusions This study is a novel amalgam of multilevel interdisciplinary strategies to translate highly efficacious therapies to low-income federally-funded health centers that care for patients who carry a disproportionate burden of CVD, type 2 diabetes and uncontrolled CVD risk factors. The impact of such a Community clinic-based intervention is potentially enormous.
Mary Donnellystrozzo - One of the best experts on this subject based on the ideXlab platform.
-
Community outreach and cardiovascular health coach trial a randomized controlled trial of nurse practitioner Community health worker cardiovascular disease risk reduction in Urban Community health centers
Circulation-cardiovascular Quality and Outcomes, 2011Co-Authors: Jerilyn K Allen, Lee R Bone, Martha N Hill, David M Levine, Cheryl Dennisonhimmelfarb, Sarah L Szanton, Murray West, Amy Barlow, Lapricia Lewisboyer, Mary DonnellystrozzoAbstract:Background—Despite well-publicized guidelines on the appropriate management of cardiovascular disease and type 2 diabetes, the implementation of risk-reducing practices remains poor. This report describes the results of a randomized, controlled clinical trial evaluating the effectiveness of a comprehensive program of cardiovascular disease risk reduction delivered by nurse practitioner /Community health worker (NP/CHW) teams versus enhanced usual care (EUC) to improve lipids, blood pressure, glycated hemoglobin (HbA1c), and patient perceptions of the quality of their chronic illness care in patients in Urban Community health centers. Methods and Results—A total of 525 patients with documented cardiovascular disease, type 2 diabetes, hypercholesterolemia, or hypertension and levels of LDL cholesterol, blood pressure, or HbA1c that exceeded goals established by national guidelines were randomly assigned to NP/CHW (n=261) or EUC (n=264) groups. The NP/CHW intervention included aggressive pharmacological mana...
-
Community outreach and cardiovascular health coach trial a randomized controlled trial of nurse practitioner Community health worker cardiovascular disease risk reduction in Urban Community health centers
Circulation-cardiovascular Quality and Outcomes, 2011Co-Authors: Jerilyn K Allen, Lee R Bone, Martha N Hill, David M Levine, Cheryl Dennisonhimmelfarb, Sarah L Szanton, Murray West, Amy Barlow, Lapricia Lewisboyer, Mary DonnellystrozzoAbstract:Background— Despite well-publicized guidelines on the appropriate management of cardiovascular disease and type 2 diabetes, the implementation of risk-reducing practices remains poor. This report describes the results of a randomized, controlled clinical trial evaluating the effectiveness of a comprehensive program of cardiovascular disease risk reduction delivered by nurse practitioner /Community health worker (NP/CHW) teams versus enhanced usual care (EUC) to improve lipids, blood pressure, glycated hemoglobin (HbA1c), and patient perceptions of the quality of their chronic illness care in patients in Urban Community health centers. Methods and Results— A total of 525 patients with documented cardiovascular disease, type 2 diabetes, hypercholesterolemia, or hypertension and levels of LDL cholesterol, blood pressure, or HbA1c that exceeded goals established by national guidelines were randomly assigned to NP/CHW (n=261) or EUC (n=264) groups. The NP/CHW intervention included aggressive pharmacological management and tailored educational and behavioral counseling for lifestyle modification and problem solving to address barriers to adherence and control. Compared with EUC, patients in the NP/CHW group had significantly greater 12-month improvement in total cholesterol (difference, 19.7 mg/dL), LDL cholesterol (difference,15.9 mg/dL), triglycerides (difference, 16.3 mg/dL), systolic blood pressure (difference, 6.2 mm Hg), diastolic blood pressure (difference, 3.1 mm Hg), HbA1c (difference, 0.5%), and perceptions of the quality of their chronic illness care (difference, 1.2 points). Conclusions— An intervention delivered by an NP/CHW team using individualized treatment regimens based on treat-to-target algorithms can be an effective approach to improve risk factor status and perceptions of chronic illness care in high-risk patients. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT00241904.
