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

BACKGROUND: 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. METHODS: 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. OBJECTIVE: To explore CHW perceptions about managing HF at home relevant to the use of home-based remote monitoring. FINDINGS: 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. CONCLUSIONS: 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.