Integrating lay health care workers into the primary care team

Objective: To describe a care model in which lay "care guides" are integrated into the primary care team to help patients with chronic disease and their providers achieve care goals.

Methods: Care guides are individuals without formal medical training who receive brief training about chronic conditions and behavior change. General activities include educating and encouraging patients to take control of their illness, supporting medication and treatment adherence, and facilitating resolution of barriers to quality care.

Results: The care guide model can improve care for some patients with chronic disease at low cost. In a randomized trial testing the intervention, patients with care guides achieved more goals than usual care patients at 1 year (odds ratio, 1.31; 95% confidence interval, 1.16-1.47; P ≤ 0.001).

Conclusion: Lay health care workers with relevant skills and training, located in clinic waiting rooms where they can meet patients and providers faceto- face, can help chronic disease patients and their providers improve the quality of care.