Is There a Role for Community Health Workers in Tobacco Cessation Programs? Perceptions of Administrators and Health Care Professionals

Bittencourt, Lorna; Scarinci, Isabel C.

doi:10.1093/ntr/ntt217

Cited by 16 publications

(11 citation statements)

References 22 publications

(24 reference statements)

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“…They included primary preventive programmes for cardiovascular disease and diabetes, focusing on lifestyle risk factors such as physical activity, diet and smoking cessation in Thailand [69], India [70], Pakistan [71], Brazil [72] and Ghana [73]; community-based screening, referral and follow-up in Kenya [74], South Africa [75], Iran [76], Brazil [77] and Pakistan [78]; and population surveillance for NCDs in India [79]. There were no reviews within or across low- and middle-income countries (LMIC) of CHW roles in chronic disease care in the period.…”

Section: Resultsmentioning

confidence: 99%

The global pendulum swing towards community health workers in low- and middle-income countries: a scoping review of trends, geographical distribution and programmatic orientations, 2005 to 2014

2016

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BackgroundThere has been a substantial increase in publications and interest in community health workers (CHWs) in low- and middle-income countries (LMIC) over the last years. This paper examines the growth, geographical distribution and programmatic orientations of the indexed literature on CHWs in LMIC over a 10-year period.MethodsA scoping review of publications on CHWs from 2005 to 2014 was conducted. Using an inclusive list of terms, we searched seven databases (including MEDLINE, CINAHL, Cochrane) for all English-language publications on CHWs in LMIC. Two authors independently screened titles/abstracts, downloading full-text publications meeting inclusion criteria. These were coded in an Excel spreadsheet by year, type of publication (e.g. review, empirical), country, region, programmatic orientation (e.g. maternal-child health, HIV/AIDS, comprehensive) and CHW roles (e.g. prevention, treatment) and further analysed in Stata14. Drawing principally on the subset of review articles, specific roles within programme areas were identified and grouped.FindingsSix hundred seventy-eight publications from 46 countries on CHWs were inventoried over the 10-year period. There was a sevenfold increase in annual number of publications from 23 in 2005 to 156 in 2014. Half the publications were reporting on initiatives in Africa, a third from Asia and 11 % from the Americas (mostly Brazil). The largest single focus and driver of the growth in publications was on CHW roles in meeting the Millennium Development Goals of maternal, child and neonatal survival (35 % of total), followed by HIV/AIDS (16 %), reproductive health (6 %), non-communicable diseases (4 %) and mental health (4 %). Only 17 % of the publications approached CHW roles in an integrated fashion. There were also distinct regional (and sometimes country) profiles, reflecting different histories and programme traditions.ConclusionsThe growth in literature on CHWs provides empirical evidence of ever-increasing expectations for addressing health burdens through community-based action. This literature has a strong disease- or programme-specific orientation, raising important questions for the design and sustainable delivery of integrated national programmes.Electronic supplementary materialThe online version of this article (doi:10.1186/s12960-016-0163-2) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

The global pendulum swing towards community health workers in low- and middle-income countries: a scoping review of trends, geographical distribution and programmatic orientations, 2005 to 2014

2016

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“…It is likely this requires low-intensity training of CHWs, and that such CHWs could also be deployed to promote preventative measures, such as encouraging vaccination or smoking cessation to reduce risk of otitis media or limitation of noise exposure to prevent noise-induced hearing loss. CHWs have been successfully used in tobacco control measures and vaccination programmes in other contexts 72 73…”

Section: Discussionmentioning

confidence: 99%

The role of community health workers in addressing the global burden of ear disease and hearing loss: a systematic scoping review of the literature

et al. 2019

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IntroductionCommunity health workers (CHWs) have the potential to improve access to ear and hearing services for people across low-income or middle-income countries, remote, underserved, or resource-poor areas of the world. We performed a systematic scoping review to identify evidence on how CHWs are currently deployed in the prevention, screening, diagnosis, treatment and management of ear disease and hearing loss; methods to train and support CHWs in this context; and cost-effectiveness of CHWs.MethodsWe performed a systematic search of the literature from September 1978 to 18 March 2018 from 11 major databases and the grey literature.ResultsWe identified 38 original studies that met the inclusion criteria, taking place across South Asia (n=13), Oceania (n=7), North America (n=7), South America (n=6) and Africa (n=5). 23 studies showed CHWs can increase community participation in screening. They can conduct screening using whispered voice tests, noisemakers for neonatal screening, automated audiological tests and otoscopy. Eight studies focused specifically on the evaluation of programmes to train CHWs, and three provided a general programme description. Three studies documented a role of CHWs in the treatment of ear disease or hearing loss, such as performing ear washouts, instillation of topical antibiotics or fitting of hearing aids. Only one study provided an indepth cost-utility analysis regarding the use of CHWs to conduct hearing screening, and no studies commented on the role of CHWs in the prevention of hearing loss.ConclusionCHWs have been employed in diverse ways to address the global burden of ear disease and hearing loss. Future research needs to explore the role of CHWs in preventative strategies, identify optimum methods to train and support CHWs, and explore their cost-effectiveness.

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“…CHWs are highly respected members of the community and health care system, and have a successful record of effectively delivering preventative services and increasing the reach of health programs (Bittencourt & Scarinci, 2014; Ogedegbe et al, 2014; Balcazar et al, 2011; Wewers et al, 2016; Rosenthal et al, 2010; Holtrop, Dosh, Torres, & Thum, 2008; Landers, 2011; de Heer, Balcazar, Castro, & Schulz, 2012). The literature also supports the effectiveness of integrating CHWs as members of the health care team to improve access to preventive services in the US and globally (Ogedegbe et al, 2014; Rosenthal et al, 2010).…”

Section: Introductionmentioning

confidence: 99%

Tobacco cessation in Vietnam: Exploring the role of village health workers

Nguyen¹,

Nguyen²,

Chapman³

et al. 2017

Global Public Health

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Purpose The purpose of this study was to explore current tobacco use treatment (TUT) practice patterns, and attitudes and beliefs among Village Health Workers (VHWs) about expanding their role to include delivering smoking cessation interventions and the perceived barriers. Methods We conducted a survey of 449 VHWs from 26 communes in Thai Nguyen province, Vietnam. We assessed TUT practices patterns including asking about tobacco use, advising smokers to quit, offering assistance (3As) and attitudes, self-efficacy, and norms related to TUT. Results Seventy two percent of VHWs reported asking patients if they use tobacco, 78.6% offered advice to quit, and 41.4% offered cessation assistance to few or more patients in the past month. Self-efficacy was low, with 53.2% agreeing that they did not have the skills to counsel patients about smoking cessation. The most commonly reported barriers to offering TUT were a lack of training and perceived lack of patient interest. Greater awareness of their commune health center’s smoke-free policy and higher levels of self-efficacy were associated with screening and offering cessation assistance. Conclusion VHWs support an expanded role in tobacco cessation but require additional resources and training to increase their self-efficacy and skills to provide effective treatment.

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Is There a Role for Community Health Workers in Tobacco Cessation Programs? Perceptions of Administrators and Health Care Professionals

Abstract: With appropriate training, health care administrators and health care professionals are very receptive regarding the involvement of CHWs in a TCP delivered through a public health system.

Cited by 16 publications

References 22 publications

The global pendulum swing towards community health workers in low- and middle-income countries: a scoping review of trends, geographical distribution and programmatic orientations, 2005 to 2014

The global pendulum swing towards community health workers in low- and middle-income countries: a scoping review of trends, geographical distribution and programmatic orientations, 2005 to 2014

The role of community health workers in addressing the global burden of ear disease and hearing loss: a systematic scoping review of the literature

Tobacco cessation in Vietnam: Exploring the role of village health workers

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