Community Health Worker Perspectives on Home-Based Care and Remote Monitoring in Heart Failure

Heart failure (HF) affects over 6 million people in the United States and is a frequent cause of hospital readmissions. While interest in individual HF interventions like digital platforms and home-based care delivered by community health workers (CHWs) has risen, few studies have explored barriers and facilitators to engaging CHWs with digital or remote monitoring devices in HF populations.

Three virtual focus groups were conducted from December 2020 to January 2021 with 14 CHWs. Key domains included: barriers and facilitators to managing HF at home; CHW care in HF; remote monitoring and technology in HF; and CHW ability to assist with remote technology in HF.

To explore CHW perceptions about managing HF at home relevant to the use of home-based remote monitoring.

Focus groups produced 4 themes: (1) patients with HF struggle to follow clinical care plans at home (i.e., medication adherence, diet, fluid intake); (2) CHWs clarify clinical care plans and provide psychosocial support; (3) CHWs connect patients to resources addressing unmet health-related social needs (e.g., transportation, rental assistance, and other needs); (4) patients face challenges understanding how to use clinician-prescribed technologies for remote monitoring that can be resolved with CHW coaching and instruction.

CHWs reported specific ways they were able to assist patients with clinical, social, and clinician-prescribed health-related technology in HF. Partnerships with CHWs are well positioned to add important value to HF home management for clinical care plan adherence and engagement, remote monitoring, and technology use.