Community Health Team Cardiovascular Disease/Diabetes Expansion Program Year 2

RIDOH, with funding from CDC, developed a network of community health teams (CHTs) which function as an extension of primary care with a focus on serving patients who are at high risk based on their chronic conditions management. CHWs completed the cardiovascular disease/diabetes mellitus (CVD/DM) specialty training and provided health coaching for patients with hypertension, diabetes and/or at risk for cardiovascular disease. The South County Hospital community health team (along with their partners Wood River Health)  and East Bay Community Action Program recently met to wrap up the 1st year of the Cardiovascular Disease/ Diabetes Expansion Program. Evaluation results were discussed including improvements in patients’ levels of confidence in their chronic conditions management and improvements in CHWs levels of confidence in providing health coaching. During the meeting, teams reported out on their successes, challenges and recommendations for improving patient engagement during the 2nd year. South County Medical Group was welcomed as a year 2 participant with discussion on new goals, structure, and deliverables for the upcoming year. Webinar Recording