Emergency department detection and follow-up of high blood pressure: Use and effectiveness of community health workers

Community Health Workers in Low-, Middle-, and High-Income Countries: An Overview of Their History, Recent Evolution, and Current Effectiveness

“…In one RCT, patients receiving support from CHWs were twice as likely as controls to achieve blood pressure control goals (11). In another review, three studies were identified that assessed CHW contributions to hypertension control, and all three reported beneficial effects; however, reviewers raised issues with the design of some of the studies (18,70,136). One earlier study, in which home visits by a CHW was one of three interventions, demonstrated a mortality reduction in patients with hypertension (80).…”

Enhancing the Role of Community‐Health Workers in Research

“…They also enhance investigators' access to community leaders, resources, and study populations (Bone et al, 1989;Butz et al, 1994;Hill & Becker, 1995;Levine et al, 1992aLevine et al, 1992bLevine et al, , and 1994. As members of a target community or population, community-health workers know the context in which health problems and possible solutions exist.…”

“…Currently, we are conducting three NIH-funded randomized clinical trials to assess the effectiveness of communityhealth workers in research programs that involve nurse and community-health worker teams: The Clinical Trial of High Blood Pressure Control in Urban Young Black Males (KO8 NR00049-03); the High Blood Pressure Control Program in an Urban African American Community (NHLBI RO1-HL 51 11 1-01); and the Community Intervention for Children with Asthma (NHLBI RO1 HL 43512-01). This article, which is based on our experience, provides a rationale for the use of community-health workers in research; describes the roles, responsibilities, and human resource issues associated with their involvement; and identifies ways to increase their effectiveness (Bone et al, 1989;Butz et al, 1994;Hill & Becker, 1995).…”

“…Community-based health aides were trained and employed to provide these services (Torrey, Smith, &Wise, 1973). Such indigenous workers have been used very successfully in a variety of programs, providing outreach, screening, and educational services in the following areas: referral, linking the elderly to health services (Robinson, Lund, Keller, & Cuervo, 1986;Kent & Smith, 1967); nutrition (Weingert, Larson & Friedman 1969); community mental health (D' Augelli, Vallance, Danish, Young, & Gerdes 1981); immunization clinics (Columbo, Freeborn, Mullooly, & Bumham, 1979;Stewart & Hood, 1970); hypertension programs (Bone, Mamon, Levine, Walrath, 1989;Finnerty, Mattie, & Finnerty, 1973;Finnerty, Shay, & Himmelsbach, 1973;Mamon et al, 1989;Richter et al, 1974); cholesterol screening (Linnan et al, 1990); smoking cessation (Stillman, Bone, Becker, Rand, & Levine, 1993); breast and cervical cancer screening (Brownstein, Cheal, Ackermann, Bassford, & Campos-Outcalt, 1992;Mamon et al, 1991); AIDS respite care (Shelp, DuBose, & Sunderland, 1990); and prenatal outreach (Meister, Warrick, Zapien, &Wood, 1992).…”

Reaching for Health Equity and Social Justice in Baltimore: The Evolution of an Academic-Community Partnership and Conceptual Framework to Address Hypertension Disparities

“…These partnerships, which found evidence supportive of the deployment of community health workers (CHWs) as a strategy for addressing HTN disparities, yielded significant associations between exposure to CHWs and improvements in several areas: appointment-keeping and continuity of care among adults using emergency departments as their usual source of care; reductions in blood pressure and increases in entry of care among young AA males; improved HTN self-management for adults receiving home visits from CHWs vs traditional care; and better HTN control for patients receiving activation coaching by CHWs vs educational newsletters only. [16][17][18][19][20] Such efforts contributed to building an evidence base asserting the need for health care providers and researchers to engage local stakeholders (eg, individual patients, community members, nonprofit/ community/faith-based organizations, educational and government institutions, insurers, and private businesses/ employers) in order to fully leverage community-based resources in support of reducing HTN disparities. 20 Although systematic reviews of community-based participatory research (CBPR) provide frameworks to guide successful community-academic partnerships, variations in effectiveness of these partnerships highlight the importance of a "fit for purpose" approach and combining communityacademic collaboration with solid research methods.…”