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The Effectiveness of Community Health Workers for CVD Prevention in LMIC

Authors:

Aditya K. Khetan ,

Department of Medicine, University Hospitals Health System, Case Western Reserve University School of Medicine, Cleveland, OH, US
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Raghunandan Purushothaman,

Department of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, US
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Tarek Chami,

Department of Medicine, University Hospitals Health System, Case Western Reserve University School of Medicine, Cleveland, OH, US
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Vittal Hejjaji,

Department of Medicine, University Hospitals Health System, Case Western Reserve University School of Medicine, Cleveland, OH, US
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Sri Krishna Madan Mohan,

Department of Medicine, Harrington Heart and Vascular Institute, University Hospitals Health System, Case Western Reserve University School of Medicine, Cleveland, OH, US
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Richard A. Josephson,

Department of Medicine, Harrington Heart and Vascular Institute, University Hospitals Health System, Case Western Reserve University School of Medicine, Cleveland, OH, US
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Allison R. Webel

Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, US
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Abstract

Community health workers (CHW) may be effective in tackling the burden of cardiovascular diseases in low- and middle-income countries (LMIC). This review examines whether CHWs can improve the identification and control of cardiovascular risk factors in LMIC. We searched for studies that used CHW as a basis for cardiovascular risk factor management. Our search yielded 11 articles that targeted cardiovascular risk factor assessment, hypertension, diabetes, smoking, diet and physical activity. There were 4 randomized controlled trials, 3 quasi-experimental studies, 3 cross-sectional studies, and 1 retrospective analysis. Eight studies reported positive results with CHW being able to effectively screen for cardiovascular risk factors, decrease systolic blood pressure, decrease fasting blood glucose, increase quit rates of smoking, decrease weight, and improve diet and physical activity. Our review demonstrates that CHW may be effective in helping tackle the burden of cardiovascular disease in LMIC.

Highlights

  • Community health workers (CHW) may be effective in cardiovascular disease prevention.
  • We conducted a systematic review of CHW in cardiovascular disease prevention in low- and middle-income countries.
  • 11 studies across 9 countries reported encouraging results, showing CHW could be effectively used to screen for cardiovascular risk factors, decrease systolic blood pressure and fasting blood glucose, increase quit rates of smoking, decrease weight, and improve diet and physical activity.
  • Most studies targeted cardiovascular risk factor assessment and/or control.
  • Due to the heterogeneity in the studies, a meta-analysis could not be conducted.
How to Cite: Khetan AK, Purushothaman R, Chami T, Hejjaji V, Madan Mohan SK, Josephson RA, et al.. The Effectiveness of Community Health Workers for CVD Prevention in LMIC. Global Heart. 2017;12(3):233–43. DOI: http://doi.org/10.1016/j.gheart.2016.07.001
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Published on 01 Sep 2017.
Peer Reviewed

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