TY - JOUR
T1 - The Baltimore Community-Based Organizations Neighborhood Network
T2 - Enhancing Capacity Together (CONNECT) Cluster RCT
AU - Wu, Albert W.
AU - Weston, Christine M.
AU - Ibe, Chidinma A.
AU - Ruberman, Claire F.
AU - Bone, Lee
AU - Boonyasai, Romsai T.
AU - Hwang, Sandra
AU - Gentry, Janice
AU - Purnell, Leon
AU - Lu, Yanyan
AU - Liang, Shuwen
AU - Rosenblum, Michael
N1 - Funding Information:
We are grateful to our CBO partners, which include many participating representatives of the Bea Gaddy Family Center, Beans and Bread, the Berea-Eastside Community Association, Centro de la Comunidad, Civic Works, Dee's Place, Esperanza Center, Franciscan Center, Green and Healthy Homes Initiative, Helping Up Mission, Jericho Reentry Program, Manna House, Maryland New Directions, McElderry Park Community Association, Moveable Feast, Oliver Community Association, Our Daily Bread Employment Center, Roberta's House, St. Vincent de Paul Church, Waxter Center for Senior Citizens, and Zion Baptist Church. This trial was funded through a grant by the Patient-Centered Outcomes Research Institute. No financial disclosures were reported by the authors of this paper.
Funding Information:
This trial was funded through a grant by the Patient-Centered Outcomes Research Institute.
Publisher Copyright:
© 2019 American Journal of Preventive Medicine
Copyright:
Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2019/8
Y1 - 2019/8
N2 - Introduction: 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. Study design: Cluster RCT. Settings/participants: 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. Intervention: 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. Main outcome measures: 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. Results: 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. Conclusions: The intervention did not improve healthcare utilization outcomes but was associated with increased healthcare staff knowledge of, and confidence in, local CBOs. Trial registration: This study is registered at www.clinicaltrials.gov NCT02222909.
AB - Introduction: 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. Study design: Cluster RCT. Settings/participants: 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. Intervention: 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. Main outcome measures: 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. Results: 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. Conclusions: The intervention did not improve healthcare utilization outcomes but was associated with increased healthcare staff knowledge of, and confidence in, local CBOs. Trial registration: This study is registered at www.clinicaltrials.gov NCT02222909.
UR - http://www.scopus.com/inward/record.url?scp=85067654466&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85067654466&partnerID=8YFLogxK
U2 - 10.1016/j.amepre.2019.03.013
DO - 10.1016/j.amepre.2019.03.013
M3 - Article
C2 - 31248746
AN - SCOPUS:85067654466
SN - 0749-3797
VL - 57
SP - e31-e41
JO - American journal of preventive medicine
JF - American journal of preventive medicine
IS - 2
ER -