The Role of Community Health Workers in Diabetes: Update on Current Literature

Shah, Megha; Kaselitz, Elizabeth; Heisler, Michele

doi:10.1007/s11892-012-0359-3

Cited by 123 publications

(100 citation statements)

References 27 publications

(25 reference statements)

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“…Of 16 studies reviewed, investigators noted that significant reductions in hemoglobin A1C values were reported in eight studies. A recent review of literature published in 2011 and 2012 assessing the evidence emerging from community-based participatory research approaches involving CHWs provided evidence of improved glycemic control or reduced risk of disease progression (2,3,7,19,43,60,61,111,116,127). Cancer screening.…”

Section: Evidence For Community Health Worker Effectiveness In the Unmentioning

confidence: 99%

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

Perry

Zulliger

Rogers

2014

Annu. Rev. Public Health

688

671

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Over the past half-century, community health workers (CHWs) have been a growing force for extending health care and improving the health of populations. Following their introduction in the 1970s, many large-scale CHW programs declined during the 1980s, but CHW programs throughout the world more recently have seen marked growth. Research and evaluations conducted predominantly during the past two decades offer compelling evidence that CHWs are critical for helping health systems achieve their potential, regardless of a country's level of development. In low-income countries, CHWs can make major improvements in health priority areas, including reducing childhood undernutrition, improving maternal and child health, expanding access to family-planning services, and contributing to the control of HIV, malaria, and tuberculosis infections. In many middle-income countries, most notably Brazil, CHWs are key members of the health team and essential for the provision of primary health care and health promotion. In the United States, evidence indicates that CHWs can contribute to reducing the disease burden by participating in the management of hypertension, in the reduction of cardiovascular risk factors, in diabetes control, in the management of HIV infection, and in cancer screening, particularly with hard-to-reach subpopulations. This review highlights the history of CHW programs around the world and their growing importance in achieving health for all.

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Section: Evidence For Community Health Worker Effectiveness In the Unmentioning

confidence: 99%

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

Perry

Zulliger

Rogers

2014

Annu. Rev. Public Health

688

671

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“…[1][2][3] As value-based payment models expand, providers will have more flexibility to fund CHWs with global budgets, or payers may elect to reimburse for CHW services. [4][5][6] The emerging evidence base on CHW programs 7 for the prevention and management of chronic diseases includes systematic reviews concluding that CHW interventions can improve overall health outcomes 8 and outcomes for patients with heart disease, stroke, 9 type II diabetes, [10][11][12] HIV, 13 and asthma 2,14 and for vulnerable patients with or at risk for a variety of chronic diseases or cancer. 15 Other systematic reviews have also documented the costs and cost-effectiveness of CHW programs, 15 but none, outside of low and middle-income countries, 16 have examined the impact of CHWs on the utilization of health services by patients with chronic conditions.…”

Section: Introductionmentioning

confidence: 99%

Impact of Community Health Workers on Use of Healthcare Services in the United States: A Systematic Review

et al. 2016

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BACKGROUND: As the US transitions to value-based healthcare, physicians and payers are incentivized to change healthcare delivery to improve quality of care while controlling costs. By assisting with the management of common chronic conditions, community health workers (CHWs) may improve healthcare quality, but physicians and payers who are making choices about care delivery also need to understand their effects on healthcare spending. METHODS: We searched PubMed, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, PsycINFO, Embase, and Web of Science from the inception of each database to 22 June 2015. We included US-based studies that evaluated a CHW intervention for patients with at least one chronic health condition and reported cost or healthcare utilization outcomes. We evaluated studies using tools specific to study design. RESULTS: Our search yielded 2,941 studies after removing duplicates. Thirty-four met inclusion and methodological criteria. Sixteen studies (47%) were randomized controlled trials (RCTs). RCTs typically had less positive outcomes than other study designs. Of the 16 RCTs, 12 reported utilization outcomes, of which 5 showed a significant reduction in one or more of ED visits, hospitalizations and/or urgent care visits. Significant reductions reported in ED visits ranged from 23%-51% and in hospitalizations ranged from 21%-50%, and the one significant reduction in urgent care visits was recorded at 60% (p < 0.05 for all). DISCUSSION: Our results suggest that CHW interventions have variable effects, but some may reduce costs and preventable utilization. These findings suggest that it is possible to achieve reductions in care utilization and cost savings by integrating CHWs into chronic care management. However, variations in cost and utilization outcomes suggest that CHWs alone do not make an intervention successful. The paucity of rigorous studies and heterogeneity of study designs limited conclusions about factors associated with reduced utilization.

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“…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 (69). Community health workers (CHWs) (70), peer supporters (71,72), and lay leaders (73) may assist in the delivery of DSMES services (61), 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" (74).…”

Section: Community Supportmentioning

confidence: 99%

1. Improving Care and Promoting Health in Populations: Standards of Medical Care in Diabetes—2018

2017

Diabetes Care

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The American Diabetes Association (ADA) “Standards of Medical Care in Diabetes” includes ADA’s current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multi-disciplinary expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA’s clinical practice recommendations, please refer to the Standards of Care Introduction. Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/content/clinical-practice-recommendations.

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The Role of Community Health Workers in Diabetes: Update on Current Literature

Cited by 123 publications

References 27 publications

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

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

Impact of Community Health Workers on Use of Healthcare Services in the United States: A Systematic Review

1. Improving Care and Promoting Health in Populations: Standards of Medical Care in Diabetes—2018

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