Developing a Model to Promote Health and Recovery after Medical Hospitalizations: Community Health Workers Teamed with Peer Specialists

Study Overview 

This study integrates a proven strategy used in general medical care (community health workers) with mental health peer-delivered services in a new intervention delivered by pairs of CHWs and CPSs to patients with co-occurring mental and physical health conditions who are hospitalized for medical conditions. The intervention is delivered at the time of inpatient treatment for a medical condition and subsequent discharge from inpatient care to the community. It is intended to prevent 30-day readmissions, and to enhance the health, mental health, and independent living of service recipients.

Study Partners

University of Illinois Hospital & Health Sciences System
The University of Illinois Hospital & Health Sciences System will serve as the setting for this study. UI Health consists of several facilities, including a 495-bed hospital (UIC Hospital), outpatient clinics, and 12 federally qualified health center clinics.

Mile Square Health Center
Mile Square is a federally-qualified health center that serves patients on Chicago’s west- and south-sides. Mile Square patients with mental illnesses who are hospitalized at the UIC Hospital for a medical condition will be approached to voluntarily participate in the study. Mile Square leadership also will contribute and co-supervise the study’s community health workers.

Collaborative Support Programs of New Jersey
The Collaborative Support Programs of New Jersey (CSPNJ) is a mental health peer-led organization that promotes responsibility, recovery, and wellness through the provision of community wellness centers, supportive and respite housing, human rights advocacy, and educational and innovative programs. CSPNJ staff will serve on the study’s participatory workgroup to help design the intervention to be tested.

Chicago Community Health Worker Local Network
The Chicago CHW Local Network is comprised of community health workers from across the city of Chicago. It is supported and advised by HealthConnect One. Network staff will serve on the study’s participatory workgroup to help design the intervention to be tested.

Midwest Latino Health Research, Training, and Policy Center
Midwest Latino Health Research, Training and Policy Center (MLHRTPC) works to improve the health status of Latinos and other racial/ethnic minorities. MLHRTPC engages in research, training, community education, and policy work. For this study, MLHRTPC staff will create the intervention manual to standardize the services to be offered by the community health worker/peer specialist teams. They also will help to train the community health workers and peer specialists.   ​​