3.5.0.0 Com­mu­ni­ty Sup­port

Iden­tification or de­vel­opment of com­mu­ni­ty re­sources to sup­port healthy lifestyles is a core el­e­ment of the CCM (9). Health care com­mu­ni­ty link­ages are re­ceiv­ing in­creas­ing at­ten­tion from the Amer­i­can Med­i­cal As­so­ci­a­tion, the Agen­cy for Health­care Re­search and Qual­i­ty, and oth­ers as a means of pro­mot­ing trans­la­tion of clin­i­cal rec­om­men­da­tions for lifestyle modification in re­al­ world set­tings (77). Com­mu­ni­ty health work­ers (CHWs) (78), peer sup­porters (79-81), and lay lead­ers (82) may as­sist in the de­liv­ery of DSMES ser­vices (66), par­tic­u­lar­ly in un­der­served com­mu­ni­ties. A CHW is defined by the Amer­i­can Pub­lic Health As­so­ci­a­tion as a “front­line pub­lic health work­er who is a trust­ed mem­ber of and/‍or has an un­usu­al­ly close un­der­standing of the com­mu­ni­ty served” (83). CHWs can be part of a cost-‍ef­fec­tive, ev­i­dence-‍based strat­e­gy to im­prove the man­age­ment of di­a­betes and car­dio­vas­cu­lar risk fac­tors in un­der­served com­mu­ni­ties and health care sys­tems (84).