Outcomes and Costs of Community Health Worker Interventions

A Systematic Review

Bibliographic Data

ID9104563
AuthorsMeera Viswanathan (0000-0003-3486-8126, Research Triangle Park Foundation, corresponding author), Jennifer L Kraschnewski (0000-0003-0998-1346, Pennsylvania State University), Brett Nishikawa (0009-0000-7459-4831), Laura C Morgan (0000-0003-1339-9746, University of North Carolina at Chapel Hill, corresponding author), Amanda A Honeycutt, Amanda Honeycutt (0000-0003-0166-1399, RTI International, corresponding author), Patricia Thieda (University of North Carolina at Chapel Hill), Kathleen N Lohr (0000-0002-3825-0713, RTI International, corresponding author), Daniel E Jonas (0000-0003-1964-8731, University of North Carolina at Chapel Hill)
Year2010
Volume48
Issue9
Pages792-808
Publication date2010-09-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0b013e3181e35b51
PMID20706166
OpenAlexW1992443460
LanguageEN
Citations received44
References cited85

OBJECTIVES: We conducted a systematic review on outcomes and costs of community health worker (CHW) interventions. CHWs are increasingly expected to improve health outcomes cost-effectively for the underserved. RESEARCH DESIGN: We searched Medline, Cochrane Collaboration resources, and the Cumulative Index to Nursing and Allied Health Literature for studies conducted in the United States and published in English from 1980 through November 2008. We dually reviewed abstracts, full-text articles, data abstractions, quality ratings, and strength of evidence grades and resolved disagreements by consensus. RESULTS: We included 53 studies on outcomes of CHW interventions and 6 on cost or cost-effectiveness. For outcomes, limited evidence (5 studies) suggests that CHW interventions can improve participant knowledge compared with alternative approaches or no intervention. We found mixed evidence for participant behavior change (22 studies) and health outcomes (27 studies). Some studies suggested that CHW interventions can result in greater improvements in participant behavior and health outcomes compared with various alternatives, but other studies suggested that CHW interventions provide no statistically different benefits than alternatives. We found low or moderate strength of evidence suggesting that CHWs can increase appropriate health care utilization for some interventions (30 studies). Six studies with economic information yielded insufficient data to evaluate the cost-effectiveness of CHW interventions relative to other interventions. CONCLUSIONS: CHWs can improve outcomes for underserved populations for some health conditions. The effectiveness of CHWs in many health care areas requires further research that addresses the methodologic limitations of prior studies and that contributes to translating research into practice

Cost effectiveness · Cost–benefit analysis · Family medicine · Health care · MEDLINE · Psychological intervention · Diabetes Management and Education · Interprofessional Education and Collaboration · Medicine · Nursing · Nursing Roles and Practices · Gerontology