Effectiveness of Community Health Workers in the Care of People with Hypertension

Brownstein, J. Nell; Chowdhury, Farah M.; Norris, Susan L.; Horsley, Tanya; Jack, Leonard; Zhang, Xuanping; Satterfield, Dawn

doi:10.1016/j.amepre.2007.01.011

Cited by 257 publications

(219 citation statements)

References 29 publications

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“…Staten et al 80 argued that questionable competency levels of CBHWs prior to studies and variability in fidelity of CBHW intervention implementation could be possible explanations for nonsignificant effects found in some studies. Previous systematic reviews 17,19 underscored the importance of required training and competency levels in relation to assigned responsibilities. Limited yet growing research has focused on the degree to which CBHWs can achieve their competency levels to serve successfully as an interventionist in vulnerable populations.…”

Section: Discussionmentioning

confidence: 99%

Effects of Community-Based Health Worker Interventions to Improve Chronic Disease Management and Care Among Vulnerable Populations: A Systematic Review

Kim¹,

Choi²,

Choi³

et al. 2016

Am J Public Health

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Section: Discussionmentioning

confidence: 99%

Effects of Community-Based Health Worker Interventions to Improve Chronic Disease Management and Care Among Vulnerable Populations: A Systematic Review

Kim¹,

Choi²,

Choi³

et al. 2016

Am J Public Health

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“…Examples of effective strategies include home BP monitoring; in-person, telephone, or web-based motivational strategies delivered by a nurse and/ or a pharmacist; collaborative management by primary carepharmacist teams; 60,61 and involvement of community health workers as members of the care team. 62 Physician-directed interventions such as continuing medical education, academic detailing, quality review and feedback, and computer decision support/reminders to change prescribing behaviors, when used alone, have not shown improvements in health outcomes, [63][64][65][66][67][68] and few studies have focused on communication skills training skills for providers. 39,61 If shown to be effective in well-designed studies, integrating the best of these strategies will provide models that may be disseminated into practice to improve quality of care and reduce disparities in cardiovascular disease outcomes.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Patient Race and Blood Pressure Control on Patient-Physician Communication

et al. 2009

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BACKGROUND: Racial disparities in hypertension control contribute to higher rates of cardiovascular mortality among blacks. Patient-physician communication quality is associated with better health outcomes, including blood pressure (BP) control. Both race/ethnicity and BP control may adversely affect communication. OBJECTIVE:To determine whether being black and having poor BP control interact to adversely affect patient-physician communication more than either condition alone, a situation referred to as "double jeopardy." DESIGN, SETTINGS, AND PATIENTS:Cross-sectional study of enrollment data from a randomized controlled trial of interventions to enhance patient adherence to therapy for hypertension. Participants included 226 hypertensive patients and 39 physicians from 15 primary care practices in Baltimore, MD. MEASUREMENTS:Communication behaviors and visit length from coding of audiotapes. RESULTS:After controlling for patient and physician characteristics, blacks with uncontrolled BP have shorter visits (B=−3.9 min, p<0.01) with less biomedical (B=−24.0, p=0.05), psychosocial (B=−19.4, p< 0.01), and rapport-building (B=−19.5, p=0.01) statements than whites with controlled BP. Of all communication outcomes, blacks with uncontrolled BP are only in "double jeopardy" for a patient positive affect-coders give them lower ratings than all other patients. Blacks with controlled BP also experience shorter visits and less communication with physicians than whites with controlled BP. There are no significant communication differences between the visits of whites with uncontrolled versus controlled BP.CONCLUSIONS: This study reveals that patient race is associated with the quality of patient-physician communication to a greater extent than BP control. Interventions that improve patient-physician communication should be tested as a strategy to reduce racial disparities in hypertension care and outcomes.

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“…12 Over the past two decades, evidence supporting the potential benefi ts of CHWs in the USA setting has grown, on the basis of a multitude of pilot programmes, particularly for mental health and chronic diseases (ie, depression, 13 diabetes, [14][15][16][17] hypertension, 18 asthma, 19,20 and cardiovascular disease). 18,21 Expanded CHW programmes are likely to be included in the present round of health-care reform.…”

Section: -4mentioning

confidence: 99%

1 million community health workers in sub-Saharan Africa by 2015

Singh¹,

Sachs²

2013

The Lancet

236

195

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During the past 10 years, community health workers (CHWs) have emerged as a focal point of international discussions of primary health-care systems. Although lay community-based health workers have been active for at least 60 years, the Millennium Development Goals (MDGs) in 2000 prompted new discussion of how these workers can help to extend primary health care from facilities to communities. CHWs have since been part of an international attempt to revise primary health-care delivery in low-income settings, and CHW programmes have been changed accordingly. Instead of being regarded as unpaid, lightly trained members of the community who focus mainly on health education and provide basic treatments, CHWs are increasingly envisioned as a trained and paid corps who give advice and treatments, and implement preventive measures. Many national governments, including those of Brazil, Pakistan, Ethiopia, and India, 1 are making CHWs a cornerstone of the scaling up of community health delivery.A key diff erence between the old and new CHW models is that workers are now viewed as an integral and formal part of the health system, with reporting lines, training, supervision, and feedback. Several develop ments have stimulated eff orts to develop a more substantial role for CHWs in primary health care; new mobile health technologies, household-administered rapid diagnostic tests, and expert support systems based on information and communications technologies (ICTs) are greatly enlarging the range of services that CHWs can eff ectively provide. New ICTs are also enabling improved training and supervision methods, and make the eff ectiveness of evidence-based com munity-based protocols delivered by CHWs easier to measure and show. [2][3][4]

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Effectiveness of Community Health Workers in the Care of People with Hypertension

Cited by 257 publications

References 29 publications

Effects of Community-Based Health Worker Interventions to Improve Chronic Disease Management and Care Among Vulnerable Populations: A Systematic Review

Effects of Community-Based Health Worker Interventions to Improve Chronic Disease Management and Care Among Vulnerable Populations: A Systematic Review

The Effect of Patient Race and Blood Pressure Control on Patient-Physician Communication

1 million community health workers in sub-Saharan Africa by 2015

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