Community Health Worker Integration into Healthcare Teams: Advancing a Theory-driven Implementation Science Model - PROJECT SUMMARY
Racial and ethnic disparities in hypertension (HTN) prevalence and control are well-documented and persist
despite targeted initiatives aimed at their reduction. The use of Community Health Workers (CHWs) has been
endorsed as a best practice to reduce HTN disparities among members of vulnerable communities. Despite the
strength of the evidence linking exposure to CHW-delivered interventions with improved HTN-related outcomes
among vulnerable populations, the sub-optimal uptake of CHW interventions across healthcare systems at large,
and barriers to CHWs’ full integration in healthcare teams in particular, may threaten efforts to utilize them in
support of patients whose psychosocial and socioeconomic circumstances require CHWs’ qualities and skillsets.
Dr. Chidinma A. Ibe is a social behavioral scientist and an Assistant Professor of General Internal Medicine at
the Johns Hopkins University School of Medicine. She seeks to support the translation and diffusion of this
innovative, effective workforce into routine care by conducting a theory-driven, systematic appraisal of the factors
contributing CHWs’ integration into care teams. She is applying for a K01 Mentored Career Development Award
in order to acquire the skills, experience, and pilot data necessary to lay the foundation for an R01 that will apply
the lessons learned in the K01 research and training period to develop interventions that optimize CHW uptake
across diverse healthcare systems. Her proposed study will examine contextual barriers to the diffusion of a
CHW intervention that formed the crux of a stepped collaborative care intervention. She will leverage the RICH
LIFE (Reducing Inequities in Care of Hypertension: Lifestyle Improvements for Everyone) Project, a pragmatic,
cluster randomized trial aimed at reducing disparities in HTN control featuring the use of CHWs embedded in
collaborative care teams, to: 1) illuminate the complement of intrapersonal, interpersonal, and structural factors
associated with the CHWs’ integration into care teams; 2) develop a theoretically-rooted measure of CHW care
team integration; 3) explore the extent to which CHWs’ integration into healthcare teams is related to patients’
cardiovascular, behavioral, care management, and process of care outcomes; and 4) use human-centered
design methods to co-develop, in partnership with key stakeholders, an organizational change intervention to
promote CHWs’ integration into care teams. Her career development plan is characterized by a blend of didactic
and experiential training in implementation science, qualitative and mixed methods, and advanced statistical
strategies, including psychometric testing. This proposed research, in combination with an exceptional mentoring
team (Primary Mentor: Dr. Lisa A. Cooper; Co-Mentor, Dr. Jill Marsteller), coursework, and participation in
relevant working groups, professional development programs, and scientific meetings, will position Dr. Ibe to
achieve her goal of becoming an independent investigator with expertise in the application of implementation
science theories and models to strengthen the development, implementation, and translation of CHW
interventions in healthcare settings.
