Community Health Workers as Healthcare Navigators in Primary Care Chronic Disease Management: a Systematic Review

Mistry, Sabuj Kanti; Harris, Elizabeth; Harris, Mark

doi:10.1007/s11606-021-06667-y

Cited by 27 publications

(29 citation statements)

References 67 publications

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“…This registry was developed by merging the households’ contact information extracted from ten different community-based studies conducted by the ARCED Foundation to explore different social issues during 2016–2020, which included households from all eight administrative divisions of Bangladesh. This registry has also been used as a sampling frame in our previous studies [ 33 , 34 ]. Considering a 50% prevalence with a 5% margin of error, at the 95% confidence level, 90% power of the test, and a 95% response rate, a sample size of 1096 was calculated.…”

Section: Methodsmentioning

confidence: 99%

Changes in Prevalence and Determinants of Self-Reported Hypertension among Bangladeshi Older Adults during the COVID-19 Pandemic

Mistry

Ali

Yadav

et al. 2022

IJERPH

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The present study aimed to assess the changes in the prevalence and determinants of self-reported hypertension among older adults during the COVID-19 pandemic in Bangladesh. This repeated cross-sectional study was conducted on two successive occasions (October 2020 and September 2021), overlapping the first and second waves of the COVID-19 pandemic in Bangladesh. The survey was conducted through telephone interviews among Bangladeshi older adults aged 60 years and above. The prevalence of hypertension was measured by asking a question about whether a doctor or health professional told the participants that they have hypertension or high blood pressure and/or whether they are currently using medication to control it. We also collected information on the socio-economic characteristics of the participants, their cognitive ability, and their COVID-19-related attributes. A total of 2077 older adults with a mean age of 66.7 ± 6.4 years participated in the study. The samples were randomly selected on two successive occasions from a pre-established registry developed by the ARCED Foundation. Thus, the sample in the 2021-survey (round two; n = 1045) was not the same as that in the 2020-survey (round one; n = 1031) but both were drawn from the same population. The findings revealed that the prevalence of hypertension significantly increased across the two periods (43.7% versus 56.3%; p = 0.006). The odds of hypertension were 1.34 times more likely in round two than in the round one cohort (AOR 1.34, 95% CI 1.06–1.70). We also found that having formal schooling, poorer memory or concentration, and having had received COVID-19 information were all associated with an increased risk of hypertension in both rounds (p < 0.05). The findings of the present study suggest providing immediate support to ensure proper screening, control, and treatment of hypertension among older adults in Bangladesh.

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Section: Methodsmentioning

confidence: 99%

Changes in Prevalence and Determinants of Self-Reported Hypertension among Bangladeshi Older Adults during the COVID-19 Pandemic

Mistry

Ali

Yadav

et al. 2022

IJERPH

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“…So far, a multi-tiered healthcare system including tertiary hospitals, secondary hospitals, and primary care facilities with an emphasis on the role of primary care facilities (e.g. community health centers) has been globally accepted as a cost-effective and sustainable way for managing chronic diseases [ 2 , 3 , 5 , 8 , 9 ]. In China, community-based primary care is currently the first level of contact for chronic disease patients into the health system, and often acts as the principal avenue for chronic disease management through the provision of community-focused, affordable, comprehensive, family-oriented, long-term and continuous care closer to home [ 3 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison of attitudes toward the medical student-led community health education service to support chronic disease self-management among students, faculty and patients

Wang

Yan

et al. 2023

BMC Med Educ

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Background Shortage of health professionals is one of the most important barriers for community health centers to provide quality primary care for chronic disease patients especially after the outbreak of COVID-19. Under such condition, medical students have been well-accepted as a force multiplier for community-based health service. Community service learning (CSL) based on medical student-led community health education service to support chronic disease self-management might be a valuable interactive learning tool in medical education. This study compared the attitudes toward medical student-led community health education service to support chronic disease self-management among three stakeholder roles in CSL, including medical students, faculty and patients. Methods This cross-sectional comparative survey was conducted using a self-developed questionnaire among the convenience samples of undergraduate students and faculty members from the Medical College, Wuhan University of Science and Technology, as well as patient volunteers with chronic diseases recruited from a free on-site clinic offered by a community health center. Attitudes toward medical student-led community health education service to support chronic disease self-management were compared among students, faculty and patients. Results A total of 515 valid questionnaires were obtained (342 were collected from medical students, 54 from faculty respondents, and 119 from patients). Overall positive attitudes toward medical student-led community health education service to support chronic disease self-management were positive. Among the three stakeholder roles, faculty and patients were more supportive of the current inadequate level of primary care provision within the community. However, patient respondents showed more negative attitudes towards using resources in higher medical education system to provide support for primary care practice, and participating in the medical student-led community health education service to support chronic disease self-management, and were most skeptical about the medical students’ competency in supporting chronic disease self-management with their professional knowledge and skills. The educational value of CSL for medical undergraduates and the role of faculty instructors were most appreciated by faculty respondents. Additionally, > 62 years old and > 2 kinds of chronic diseases per patient exhibited significant correlations with positive patients’ attitudes. Conclusions Medical students, faculty and patients had overall positive attitudes towards CSL based on medical student-led community health education service to support chronic disease self-management. However, more should be done to create higher expectations and enthusiasm of patients about CSL.

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“…Community health workers (CHWs) have become a mainstay of human resources for NCDs management in community. A CHW-led, interdisciplinary-enabled NCDs care model can feasibly screen high-risk factors and implement lifestyle interventions, lower disease complications, reduce hospitalization, cut down health expenditures and effectively improve health outcomes and quality of life [9][10][11][12][13][14]. In China, despite efforts to address NCDs management in community, this issue is perpetuated by low capability and supply mismatch, low patient trust, heavy workload, ine cient referral system, inadequate numbers of trained and quali ed human resources [15][16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

A situational analysis of human resource and non-communicable diseases management for community health workers in Chengdu, China: A cross-sectional study

Chen

Guo

et al. 2022

Preprint

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Background Non-communicable diseases (NCDs) pose a major challenge to health economic cost and residents’ health status. Community health workers (CHWs) are the gatekeeper of primary health care. Objective This study aimed to conduct a situational analysis of the current human resource and requirement of NCDs-related training in Chengdu with regard to address to understand the suggestions for improvement of challenges and barriers. Methods A descriptive online cross-sectional survey was conducted among CHWs (doctor and nurse) from 23 districts and counties in Chengdu. Sociodemographic and NCDs-related variables were collected. Univariate analysis and multiple response analysis were used to describe the characteristics of these variables. Results 711 doctors and 637 nurses completely responded. There were significant differences among gender, age, educational levels, professional title, working year, type of institution, urban circle and registration in general practice between doctors and nurses (P < 0.001). The proportions of NCDs’ category, NCDs-related roles and tasks, NCDs-related training contents and forms that CHWs have attend and hoped to gain more were significantly different between doctors and nurses (P < 0.001). In general, the proportions in nurses were much lower than those of doctors (P < 0.05). The top five diseases managed by CHWs were hypertension, diabetes, cerebrovascular disease, chronic respiratory diseases and mental diseases. The five most reported roles performed among doctors included the distribution of health education (91.4%), following up (85.9%), establishing archives (71.3%), medicine adjustment (64.7%) and treatment implementation (27.8%). The top three diseases managed by nurses were same with doctors. The top four and five tasks were contact with patients or health services (39.6%) and referral (16.6%) in nurses. Most CHWs had received primary and common diseases-related trainings, but they had few opportunities to study in a tertiary hospital (40.4% in doctors and 20.9% in nurses, respectively), attend domestic academic conferences (26.9% in doctors vs 9.7% in nurses), and take part in training courses (44.9% in nurses). CHWs hoped that the above-discussed training contents and forms could be provided more in the future. Besides basic skills related trainings, some specific skills related trainings should be strengthened. Conclusion The qualifications in doctors were much better than those of nurses. The roles performed by CHWs in NCDs management are varied form common and frequent disease management to subsequent follow up and supervision. CHWs hope to receive more desired and oriented trainings. There is a need for building capacity of CHWs, optimizing and defining CHWs’ role, facilitating postgraduate medical education support and strengthening multidisciplinary collaboration would be effective in NCDs management.

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Community Health Workers as Healthcare Navigators in Primary Care Chronic Disease Management: a Systematic Review

Cited by 27 publications

References 67 publications

Changes in Prevalence and Determinants of Self-Reported Hypertension among Bangladeshi Older Adults during the COVID-19 Pandemic

Changes in Prevalence and Determinants of Self-Reported Hypertension among Bangladeshi Older Adults during the COVID-19 Pandemic

Comparison of attitudes toward the medical student-led community health education service to support chronic disease self-management among students, faculty and patients

A situational analysis of human resource and non-communicable diseases management for community health workers in Chengdu, China: A cross-sectional study

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