Outcomes and costs of community health worker interventions: A systematic review

Meera Viswanathan, Jennifer L. Kraschnewski, Brett Nishikawa, Laura C. Morgan, Amanda A. Honeycutt, Patricia Thieda, Kathleen N. Lohr, Daniel E. Jonas

Research output: Contribution to journalArticle

127 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)792-808
Number of pages17
JournalMedical care
Volume48
Issue number9
DOIs
StatePublished - Sep 1 2010

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Costs and Cost Analysis
Health
Cost-Benefit Analysis
Patient Acceptance of Health Care
Outcome Assessment (Health Care)
Vulnerable Populations
Research
Health Care Costs
Nursing
Research Design
Economics
Delivery of Health Care

All Science Journal Classification (ASJC) codes

  • Public Health, Environmental and Occupational Health

Cite this

Viswanathan, M., Kraschnewski, J. L., Nishikawa, B., Morgan, L. C., Honeycutt, A. A., Thieda, P., ... Jonas, D. E. (2010). Outcomes and costs of community health worker interventions: A systematic review. Medical care, 48(9), 792-808. https://doi.org/10.1097/MLR.0b013e3181e35b51
Viswanathan, Meera ; Kraschnewski, Jennifer L. ; Nishikawa, Brett ; Morgan, Laura C. ; Honeycutt, Amanda A. ; Thieda, Patricia ; Lohr, Kathleen N. ; Jonas, Daniel E. / Outcomes and costs of community health worker interventions : A systematic review. In: Medical care. 2010 ; Vol. 48, No. 9. pp. 792-808.
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Viswanathan, M, Kraschnewski, JL, Nishikawa, B, Morgan, LC, Honeycutt, AA, Thieda, P, Lohr, KN & Jonas, DE 2010, 'Outcomes and costs of community health worker interventions: A systematic review', Medical care, vol. 48, no. 9, pp. 792-808. https://doi.org/10.1097/MLR.0b013e3181e35b51

Outcomes and costs of community health worker interventions : A systematic review. / Viswanathan, Meera; Kraschnewski, Jennifer L.; Nishikawa, Brett; Morgan, Laura C.; Honeycutt, Amanda A.; Thieda, Patricia; Lohr, Kathleen N.; Jonas, Daniel E.

In: Medical care, Vol. 48, No. 9, 01.09.2010, p. 792-808.

Research output: Contribution to journalArticle

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AU - Honeycutt, Amanda A.

AU - Thieda, Patricia

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AU - Jonas, Daniel E.

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