Community Health Workers for Learning Difficulties

(HERE Trial)

Overseen By Kelsey Dean

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: University of Kansas Medical Center

Disqualifiers: Profound intellectual/cognitive disability

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

126 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores the effectiveness of using community health workers in schools to assist students who struggle with regular attendance. The main focus is to determine if a school-based community health worker (SB-CHW) can facilitate access to necessary support for students and their families, particularly in rural areas. The trial includes two groups: one where students meet with a community health worker and another where students receive regular care, supplemented with more information on available social services. It seeks students in grades 6-12 from Southeast Kansas with a history of frequent absences. As an unphased trial, this study provides a unique opportunity for students to access additional support and resources that could enhance their attendance and overall well-being.

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications.

What prior data suggests that these methods are safe for students with poor school attendance?

Research shows that programs led by community health workers (CHWs) are generally safe and yield positive results in various settings. Studies have found that CHWs effectively assist children and parents in schools. These programs address health needs, improve attendance, and support mental health.

Although limited data exists on negative effects in schools, CHW programs have been implemented successfully in many communities without major safety issues. They are designed to be helpful and meet individual needs. School-based health centers, which often collaborate with CHWs, are also considered safe and beneficial for students, providing services like medical and mental health support.

Overall, evidence suggests that CHW programs in schools are safe for participants and offer important health benefits. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the School-Based Community Health Worker (SB-CHW) intervention because it introduces a new approach to supporting students with learning difficulties. Unlike traditional methods that often rely solely on classroom strategies or medical interventions, this treatment integrates community health workers directly into schools. This unique delivery method aims to provide personalized support and bridge the gap between healthcare and education. By involving community health workers, the intervention hopes to offer more holistic and accessible care for students, potentially leading to better educational outcomes and overall well-being.

What evidence suggests that this trial's treatments could be effective for improving school attendance?

This trial will compare the School-Based Community Health Worker (SB-CHW) intervention with Enhanced Usual Care (EUC) methods. Research has shown that community health workers (CHWs) in schools can improve student health by addressing issues affecting school attendance. A review of studies found that CHW-led programs focusing on children and parents can boost health and school involvement. Although experts have not fully agreed on the effectiveness of these programs in schools, early results appear promising. CHWs help families find resources to meet their social and health needs, reducing obstacles to school attendance. This approach aims to enhance students' mental and behavioral health by facilitating access to support services. ^{1 2 3 6 7}

Who Is on the Research Team?

Eve-Lynn Nelson, PhD

Principal Investigator

University of Kansas Medical Center

Are You a Good Fit for This Trial?

The HERE! Clinical Trial is for rural students in grades 6-12 who struggle with school attendance and their parents or guardians. Participants should be facing social challenges that affect schooling. The trial excludes those not fitting the age or grade criteria, living outside of rural areas, or unable to commit to the intervention's requirements.

Inclusion Criteria

Student with or at risk for chronic poor attendance (missing 10% or more of the days that school has been in session at any point in the school year)

I am a student and at least 12 years old.

I am a parent/guardian of a child aged 12-18 in Southeast Kansas.

Exclusion Criteria

Parents/guardians or youth with profound intellectual/cognitive disability will be excluded.

Timeline for a Trial Participant

Stakeholder Interviews

Phase I interviews with stakeholders to inform the school-based community health worker and enhanced usual care conditions

6 months

School-based Community Health Worker Intervention

Implementation of the School-Based Community Health Worker intervention to support students with poor school attendance

18 months

Enhanced Usual Care

Comparator phase where enhanced usual care is provided without a school-based community health worker

18 months

Follow-up

Participants are monitored for outcomes such as school attendance and health service utilization

10 months

What Are the Treatments Tested in This Trial?

Interventions

• Enhanced Usual Care (EUC) Methods
• School-Based Community Health Worker (SB-CHW) intervention

Trial Overview This study tests a School-Based Community Health Worker (SB-CHW) intervention against Enhanced Usual Care (EUC). It aims to see if it's possible to recruit families for these programs, carry out a trauma-informed approach, and measure improvements in health needs, clinic use, and behavioral symptoms.

How Is the Trial Designed?

Group I: Study Phase II: School-based Community Health Worker Intervention Experimental Treatment 1 Intervention

The School-Based Community Health Worker (SB-CHW) intervention is the active intervention in the Phase II feasibility trial.

Group II: Study Phase II: Enhanced Usual Care Active Control 1 Intervention

Enhanced usual care (EUC) is the comparator in the Phase II feasibility trial.

Group III: Study Phase I: Stakeholder Interviews Active Control 1 Intervention

Phase I interviews with stakeholders (Community Advisory Board members, CHWs, community members, students Grade 6-12, \& parent stakeholders) will be completed to inform the school-based community health worker and the enhanced usual care conditions in the Phase 2 feasibility pilot.

Who Is Running the Clinical Trial?

University of Kansas Medical Center

Lead Sponsor

Trials

527

Recruited

181,000+

National Institute of Nursing Research (NINR)

Collaborator

Trials

623

Recruited

10,400,000+

National Institutes of Health (NIH)

Collaborator

Trials

2,896

Recruited

8,053,000+

Published Research Related to This Trial

Community health worker (CHW) interventions, particularly those involving home visits and women's groups, can improve equitable access to maternal and newborn health services in low-income and middle-income countries, as shown in a review of 22 studies.

While some CHW interventions have successfully reduced health inequities, others have not, indicating that the effectiveness of these programs can vary based on the type of intervention and the support provided to CHWs in their communities.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of community health worker interventions on socioeconomic inequities in maternal and newborn health in low-income and middle-income countries: a mixed-methods systematic review. Blanchard, AK., Prost, A., Houweling, TAJ.[2022]

A community health worker (CHW) intervention significantly improved long-term self-management of type 2 diabetes in patients facing social disadvantages, with 33% achieving self-care generativity after engaging with the program.

Patients who reached self-care generativity showed greater declines in hemoglobin A1c (HbA1c) levels over time, averaging 8.5% compared to 8.8% and 9.0% in other groups, and had lower rates of emergency department and hospital visits, indicating improved health outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Community Health Workers as Trust Builders and Healers: A Cohort Study in Primary Care. Ferrer, RL., Schlenker, CG., Cruz, I., et al.[2022]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10320159/

Community health workers' perspectives on integrating into ... This study is the first to examine perspectives of experienced CHWs about how CHWs can be applied in school settings to support student health.

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9951773/

Community health workers in schools: a systematic review This systematic literature review examined articles that described an intervention led by community health workers, targeted children and/or parents.

3. sciencedirect.com sciencedirect.com/science/article/abs/pii/S1538544224000336

The Role of School-Based Health Centers (SBHCs) This review will focus on the history and current state of SBHCs in the United States, the role of SBHCs in advancing health equity, with a specific focus on ...

4. researchgate.net researchgate.net/publication/364288589_Community_health_workers_in_schools_a_systematic_review

Community Health Workers in Schools: A Systematic Review However, no consensus exists regarding whether community health worker-based interventions are effective within the school setting. Objective To ...

5. academicpedsjnl.net academicpedsjnl.net/article/S1876-2859(22)00425-9/abstract

Community Health Workers in Schools: A Systematic Review This systematic literature review examined articles that described an intervention led by community health workers, targeted children and/or parents, ...

6. jamanetwork.com jamanetwork.com/journals/jama-health-forum/fullarticle/2829714

Role of School Nurses in the Health and Education ... Research shows that school-based health centers and school nursing services are cost-effective, with significant returns on investment, ...

7. ahrq.gov ahrq.gov/downloads/pub/evidence/pdf/comhealthwork/comhwork.pdf

Outcomes of Community Health Worker Interventions To conduct a systematic review of the evidence on characteristics of community health workers (CHWs) and CHW interventions, outcomes of such interventions, ...