Clinical-Community Relationships Measures (CCRM) Atlas

Exhibit 5-16. Measure 16: CHERL referrals to community resources

Domain:Referral processElement/ relationship:Patient-community resource
Purpose:This measure calculates the proportion of patients working with a CHERL who were referred to at least one community resource that provided assistance with one or more of the four unhealthy behaviors.
Format/data source:Electronic health/medical record. A computerized support system was developed to collect patient data; track patient calls, dates of service, and clinician feedback; and guide the counseling. Patient-specific health behavior and demographic information was entered by the CHERL based on self-report by the patients.
Measure type:ProcessDate:2006
Preventive service/ USPSTF:Alcohol Misuse Counseling; Healthy Diet Counseling; Obesity Screening and Counseling—Adults; Tobacco Use Counseling and Interventions—Non-Pregnant
Clinical practice:Primary Care—Family Practice; Primary Care—Internal Medicine
Denominator: Number of eligible patients (those identified by the clinician as needing improvement in one or more unhealthy behavior): Patients eligible for improvement were those who had smoked one puff or more in past 7 days; had drunk two alcoholic drinks per one occasion most days in the past month; did not eat a low-fat diet or at least five total fruits and/or vegetables per day; and/or did not participate in moderate exercise at least 5 days per week, or vigorously at least 3 days per week. The patient must have completed a baseline call with the CHERL.
Numerator:The number of clients who received at least one referral from the CHERL to a community resource.
Development & testing:The Reach, Efficacy/Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) model provided the framework for the analysis of study results.
Past or validated application:Adult patients at 15 practices selected for convenience in three Michigan communities were eligible for CHERL referral if a patient was identified by the clinician as needing improvement in one or more of the four unhealthy behaviors.
Citation(s):Holtrop, J. S., Dosh, S. A., Torres, T., Thum, Y. M. The community health educator referral liaison (CHERL): A primary care practice role for promoting healthy behaviors. American Journal of Preventive Medicine (2008) 35:S365-S372.

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Page last reviewed March 2013
Internet Citation: Clinical-Community Relationships Measures (CCRM) Atlas: Exhibit 5-16. Measure 16: CHERL referrals to community resources. March 2013. Agency for Healthcare Research and Quality, Rockville, MD.