Effects of Community-Based Health Worker Interventions to Improve Chronic Disease Management and Care Among Vulnerable Populations: A Systematic Review.
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| Title: | Effects of Community-Based Health Worker Interventions to Improve Chronic Disease Management and Care Among Vulnerable Populations: A Systematic Review. |
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| Authors: | Kyounghae Kim (NURSE), Choi, Janet S., Eunsuk Choi (NURSE), Nieman, Carrie L., Jin Hui Joo, Lin, Frank R., Gitlin, Laura N., Hae-Ra Han (NURSE) |
| Source: | American Journal of Public Health. Apr2016, Vol. 106 Issue 4, pe3-e28. 26p. |
| Subjects: | Chronic diseases, Community health workers, Confidence intervals, Medical quality control, At-risk people, Data analysis software, Descriptive statistics, Odds ratio, Psychology |
| Abstract: | Background. Community-based health workers (CBHWs) are frontline public health workers who are trusted members of the community they serve. Recently, considerable attention has been drawn to CBHWs in promoting healthy behaviors and health outcomes among vulnerable populations who often face health inequities. Objectives. We performed a systematic review to synthesize evidence concerning the types of CBHW interventions, the qualification and characteristics of CBHWs, and patient outcomes and cost-effectiveness of such interventions in vulnerable populations with chronic, non-communicable conditions. Search methods. We undertook 4 electronic database searches--PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature, and Cochrane--and hand searched reference collections to identify randomized controlled trials published in English before August 2014. Selection. We screened a total of 934 unique citations initially for titles and abstracts. Two reviewers then independently evaluated 166 full-text articles that were passed onto review processes. Sixty-one studies and 6 companion articles (e.g., cost-effectiveness analysis) met eligibility criteria for inclusion. Data collection and analysis. Four trained research assistants extracted data by using a standardized data extraction form developed by the authors. Subsequently, an independent research assistant reviewed extracted data to check accuracy. Discrepancies were resolved through discussions among the study team members. Each study was evaluated for its quality by 2 research assistants who extracted relevant study information. Interrater agreement rates ranged from 61% to 91% (average 86%). Any discrepancies in terms of quality rating were resolved through team discussions. Main results. All but 4 studies were conducted in the United States. The 2 most common areas for CBHW interventions were cancer prevention (n = 30) and cardiovascular disease risk reduction (n = 26). The roles assumed by CBHWs included health education (n = 48), counseling (n = 36), navigation assistance (n = 21), case management (n = 4), social services (n = 7), and social support (n = 18). Fifty-three studies provided information regarding CBHW training, yet CBHW competency evaluation (n = 9) and supervision procedures (n = 24) were largely under-reported. The length and duration of CBHW training ranged from 4 hours to 240 hours with an average of 41.3 hours (median: 1 6.5 hours) in 24 studies that reported length of training. Eight studies reported the frequency of supervision, which ranged from weekly to monthly. There was a trend toward improvements in cancer prevention (n = 21) and cardiovascular risk reduction (n = 16). Eight articles documented cost analyses and found that integrating CBHWs in to the health care delivery system was associated with cost-effective and sustainable care. Conclusions. Interventions by CBHWs appear to be effective when compared with alternatives and also cost-effective for certain health conditions, particularly when partnering with low-income, underserved, and racial and ethnic minority communities. Future research is warranted to fully incorporate CBHWs into the health care system to promote noncommunicable health outcomes among vulnerable populations. [ABSTRACT FROM AUTHOR] |
| Copyright of American Journal of Public Health is the property of American Public Health Association and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Psychology and Behavioral Sciences Collection |
| FullText | Links: – Type: pdflink Text: Availability: 0 |
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| Header | DbId: pbh DbLabel: Psychology and Behavioral Sciences Collection An: 113642840 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: Effects of Community-Based Health Worker Interventions to Improve Chronic Disease Management and Care Among Vulnerable Populations: A Systematic Review. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Kyounghae+Kim%22">Kyounghae Kim</searchLink> (NURSE)<br /><searchLink fieldCode="AR" term="%22Choi%2C+Janet+S%2E%22">Choi, Janet S.</searchLink><br /><searchLink fieldCode="AR" term="%22Eunsuk+Choi%22">Eunsuk Choi</searchLink> (NURSE)<br /><searchLink fieldCode="AR" term="%22Nieman%2C+Carrie+L%2E%22">Nieman, Carrie L.</searchLink><br /><searchLink fieldCode="AR" term="%22Jin+Hui+Joo%22">Jin Hui Joo</searchLink><br /><searchLink fieldCode="AR" term="%22Lin%2C+Frank+R%2E%22">Lin, Frank R.</searchLink><br /><searchLink fieldCode="AR" term="%22Gitlin%2C+Laura+N%2E%22">Gitlin, Laura N.</searchLink><br /><searchLink fieldCode="AR" term="%22Hae-Ra+Han%22">Hae-Ra Han</searchLink> (NURSE) – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22American+Journal+of+Public+Health%22">American Journal of Public Health</searchLink>. Apr2016, Vol. 106 Issue 4, pe3-e28. 26p. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Chronic+diseases%22">Chronic diseases</searchLink><br /><searchLink fieldCode="DE" term="%22Community+health+workers%22">Community health workers</searchLink><br /><searchLink fieldCode="DE" term="%22Confidence+intervals%22">Confidence intervals</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+quality+control%22">Medical quality control</searchLink><br /><searchLink fieldCode="DE" term="%22At-risk+people%22">At-risk people</searchLink><br /><searchLink fieldCode="DE" term="%22Data+analysis+software%22">Data analysis software</searchLink><br /><searchLink fieldCode="DE" term="%22Descriptive+statistics%22">Descriptive statistics</searchLink><br /><searchLink fieldCode="DE" term="%22Odds+ratio%22">Odds ratio</searchLink><br /><searchLink fieldCode="DE" term="%22Psychology%22">Psychology</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Background. Community-based health workers (CBHWs) are frontline public health workers who are trusted members of the community they serve. Recently, considerable attention has been drawn to CBHWs in promoting healthy behaviors and health outcomes among vulnerable populations who often face health inequities. Objectives. We performed a systematic review to synthesize evidence concerning the types of CBHW interventions, the qualification and characteristics of CBHWs, and patient outcomes and cost-effectiveness of such interventions in vulnerable populations with chronic, non-communicable conditions. Search methods. We undertook 4 electronic database searches--PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature, and Cochrane--and hand searched reference collections to identify randomized controlled trials published in English before August 2014. Selection. We screened a total of 934 unique citations initially for titles and abstracts. Two reviewers then independently evaluated 166 full-text articles that were passed onto review processes. Sixty-one studies and 6 companion articles (e.g., cost-effectiveness analysis) met eligibility criteria for inclusion. Data collection and analysis. Four trained research assistants extracted data by using a standardized data extraction form developed by the authors. Subsequently, an independent research assistant reviewed extracted data to check accuracy. Discrepancies were resolved through discussions among the study team members. Each study was evaluated for its quality by 2 research assistants who extracted relevant study information. Interrater agreement rates ranged from 61% to 91% (average 86%). Any discrepancies in terms of quality rating were resolved through team discussions. Main results. All but 4 studies were conducted in the United States. The 2 most common areas for CBHW interventions were cancer prevention (n = 30) and cardiovascular disease risk reduction (n = 26). The roles assumed by CBHWs included health education (n = 48), counseling (n = 36), navigation assistance (n = 21), case management (n = 4), social services (n = 7), and social support (n = 18). Fifty-three studies provided information regarding CBHW training, yet CBHW competency evaluation (n = 9) and supervision procedures (n = 24) were largely under-reported. The length and duration of CBHW training ranged from 4 hours to 240 hours with an average of 41.3 hours (median: 1 6.5 hours) in 24 studies that reported length of training. Eight studies reported the frequency of supervision, which ranged from weekly to monthly. There was a trend toward improvements in cancer prevention (n = 21) and cardiovascular risk reduction (n = 16). Eight articles documented cost analyses and found that integrating CBHWs in to the health care delivery system was associated with cost-effective and sustainable care. Conclusions. Interventions by CBHWs appear to be effective when compared with alternatives and also cost-effective for certain health conditions, particularly when partnering with low-income, underserved, and racial and ethnic minority communities. Future research is warranted to fully incorporate CBHWs into the health care system to promote noncommunicable health outcomes among vulnerable populations. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of American Journal of Public Health is the property of American Public Health Association and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.2105/AJPH.2015.302987 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 26 StartPage: e3 Subjects: – SubjectFull: Chronic diseases Type: general – SubjectFull: Community health workers Type: general – SubjectFull: Confidence intervals Type: general – SubjectFull: Medical quality control Type: general – SubjectFull: At-risk people Type: general – SubjectFull: Data analysis software Type: general – SubjectFull: Descriptive statistics Type: general – SubjectFull: Odds ratio Type: general – SubjectFull: Psychology Type: general Titles: – TitleFull: Effects of Community-Based Health Worker Interventions to Improve Chronic Disease Management and Care Among Vulnerable Populations: A Systematic Review. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Kyounghae Kim – PersonEntity: Name: NameFull: Choi, Janet S. – PersonEntity: Name: NameFull: Eunsuk Choi – PersonEntity: Name: NameFull: Nieman, Carrie L. – PersonEntity: Name: NameFull: Jin Hui Joo – PersonEntity: Name: NameFull: Lin, Frank R. – PersonEntity: Name: NameFull: Gitlin, Laura N. – PersonEntity: Name: NameFull: Hae-Ra Han IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 04 Text: Apr2016 Type: published Y: 2016 Identifiers: – Type: issn-print Value: 00900036 Numbering: – Type: volume Value: 106 – Type: issue Value: 4 Titles: – TitleFull: American Journal of Public Health Type: main |
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