Community health worker navigation to improve allostatic load: The Integrated Population Health (IPOP) study

Area of Science:

• Public Health
• Health Disparities
• Behavioral Science

Background:

• Social determinants of health (SDOH) and cumulative stress are key drivers of chronic disease.
• Allostatic load measures the physiological impact of chronic stress, particularly in low-income populations.
• Current patient navigation programs show limited success in improving chronic disease outcomes despite addressing SDOH.

Purpose of the Study:

• To evaluate a novel community health worker (CHW) navigation intervention for poverty-stressed adults.
• To assess the intervention's effectiveness in improving access to social and medical services and providing social support.
• To determine the impact of CHW navigation on allostatic load and chronic disease risk factors.

Main Methods:

• A randomized, parallel two-arm study (Integrated Population Health Study - IPOP).
• Intervention group received CHW navigation alongside an integrated population health program (IPOP CHW).
• Control group received usual care (population health program only - IPOP).

Main Results:

• 202 participants (mean age 58.15 ± 12.03) were randomized.
• 74.75% female, 79.21% Black/African American, 17.33% Hispanic.
• 100 participants in IPOP CHW arm, 102 in IPOP Only arm.

Conclusions:

• This study assesses if theory-based CHW navigation can guide individuals to address social/medical needs and improve allostatic load.
• Evidence-based interventions addressing SDOH have significant clinical and policy implications for improving population health.
• Findings could inform healthcare systems, non-profits, and government entities on effective SDOH interventions.