In this issue of JAMA Internal Medicine, Kangovi et al build on their previously published work with the IMPaCT intervention, a standardized program that applies a specific tool-box and strategy across a variety of settings. The consistency of IMPaCT is a strength that is comparable with many other interventions that have differing definitions of CHWs and heterogeneous metrics for success.
Having demonstrated improvements in health-related outcomes among inpatients and outpatients at 2 academic medical centers via IMPaCT, the current study looks at similar outpatient-focused health improvements in a greater diversity of primary care sites: academic medical center, federally qualified health center, and Veterans Affairs facility. The authors report mixed results. The primary outcome measure of self-rated physical health slightly worsened, although this was not statistically significant and no change in disease-related quality metrics was observed; the secondary outcomes of hospitalizations and patient-reported receipt of high-quality primary care improved favorably in the intervention group.
