Unsung heroes in health education and promotion: How Community Health Workers contribute to hypertension management

Abstract

Rural communities are noted as having poor health outcomes. Rural areas experience barriers to care primarily due to a lack of resources, including education, health insurance, transportation, and social support. Additionally, poor health outcomes are a consequence of poor health literacy skills. Community Health Workers (CHWs) are utilized as a resource to combat these issues. This study focused on a CHW led Self-Management Blood Pressure (SMBP) program offered through the University of Texas at Tyler Health Science Center. The goal of the program was to improve management of hypertension through awareness, education, navigation, advocacy, and resource assistance. The SMBP program included structured workshops and regular follow-up with participants including connections to community resources and social support. CHWs worked closely with physicians providing bi-directional feedback on referrals and engagement of communities through outreach events. Furthermore, CHWs aided to bridge cultural or linguistic gaps between service providers and community members. Data is provided indicating this CHW-led intervention played a significant role in improving hypertension through education of how to make lifestyle changes that impact overall health and quality of life. Participants gained knowledge encouraging them to create lifelong healthy habits, coping skills, stress management, self-care, and accountability. Through this innovative approach, participants thrived in the supportive and encouraging environment led by CHWs as well as improved their blood pressure management.

Lay advisor interventions for hypertension outcomes: A Systematic Review, Meta-analysis and a RE-AIM evaluation

“…Of the 41 articles meeting inclusion criteria, 22 were RCTs (16-37) and 19 were non-randomized studies including process assessments and matched cohort studies (38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53)(54)(55)(56). Of the 22 RCTs, 13 RCTs were done in the US (16, 17, 21, 24, 26, 27, 29-31, 33, 35-37).…”

“…Eight non-randomized studies reported qualitative assessments to understand outcomes (39,41,42,(50)(51)(52)(53)56); one of these was mainly a process evaluation of a sustained peer leader program for Veterans (39). One pragmatic randomized study included process evaluation in their protocol, but published article mentions challenges with balancing external validity and intervention assessments (19,58).…”

Evaluating the Effectiveness of a Patient-Centered, Nonphysician Led Self-Monitoring Blood Pressure Program in a Rural Federally Qualified Health Center

“…Federally qualified health centers provide care to all populations regardless of their ability to pay and can reduce barriers to care. They are also primed to incorporate nonclinical staff, such as community health workers (CHWs), to build community capacity and improve health outcomes in underserved communities 11. Studying the effectiveness of an SMBP program, especially in rural areas, is crucial due to limited resources and high demand for hypertension management.…”