CVD

Observational Stepped-Wedge Analysis of a CHW-Led Intervention for Diabetes and Hypertension in Rural Mexico

BMJ Open. 2020 Mar 8;10(3):e034749. [Pubmed Abstract]

Worster DT, Franke MF, Bazúa R, Flores H, García Z, Krupp J, Maza J, Palazuelos L, Rodríguez K, Newman PM, Palazuelos D

Objectives
There is emerging interest and data supporting the effectiveness of community health workers (CHWs) in non-communicable diseases (NCDs) in low/middle-income countries (LMICs). This study aimed to determine whether a CHW-led intervention targeting diabetes and hypertension could improve markers of clinical disease control in rural Mexico.

Design and setting
A prospective observational stepped-wedge study was conducted across seven communities in rural Chiapas, Mexico from March 2014 to April 2018.

Participants
149 adults with hypertension and/or diabetes.

Intervention
This study was conducted in the context of the programmatic roll-out of an accompaniment-based CHW-led intervention designed to complement comprehensive primary care for adults with diabetes and/or hypertension….

Cost-effectiveness of a statewide public health intervention to reduce cardiovascular disease risk

BMC Public Health. 2019 Sep 6;19(1):1234. [Pubmed Abstract]

Smith L, Atherly A, Campbell J, Flattery N, Coronel S, Krantz M

Bacgkround
The cost-effectiveness of community health worker (CHW)-based cardiovascular disease (CVD) risk-reduction interventions is not well established. Colorado Heart Healthy Solutions is a CHW-based intervention designed to reduce modifiable CVD risk factors. This program has previously demonstrated success, but the cost-effectiveness is unknown. CHW-based interventions are potentially attractive complements to healthcare delivery because laypersons implement the intervention at a lower cost relative to medical care and may be attractive in rural settings with limited clinical resources.

Method
CHWs performed screenings and provided ongoing participant support within predominantly rural communities. A point-of-service software tool was used to generate 10-year Framingham CVD risk scores and assist CHWs to make medical referrals and provide ongoing…

The Effectiveness of CHWs in CVD Prevention in LMIC

Glob Heart. 2016 Dec 16. [Pubmed Abstract]

Khetan AK, Purushothaman R, Chami T, Hejjaji V, Madan Mohan SK, Josephson RA, Webel AR

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…