Systematic review of U.S.-based randomized controlled trials using community health workers.
Systematic review of U.S.-based randomized controlled trials using community health workers.
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DOI：
10.1353/cpr.2007.0035
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发表时间：
2007-01-01
期刊：
影响因子：
--
通讯作者：
Tyus, Nadra C
中科院分区：
文献类型：
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作者：
Gibbons, M Christopher;Tyus, Nadra C
背景：在美国，人们越来越关注健康状况和医疗保健方面的种族和民族差异。最近的建议，以解决这些差距，鼓励使用社区卫生工作者（CHW）作为一个有前途的intervention.Acceptives：本次审查的目的是提供一个随机对照试验（RCT）证据的有用性CHW在美国卫生保健系统的系统性检查。我们检索了1990年1月1日至2007年6月7日的电子数据库，以确定使用CHW的RCT。两名研究人员系统地审查了所有符合条件的文章。从每个符合条件的研究中提取数据，并由两位调查员独立审查。结果：12项研究符合纳入本审查。在这12项研究中，有10项证明了CHW在改善结局方面的疗效。其中三项研究涉及乳腺癌筛查行为，三项研究评估了巴氏涂片检查。该综述发现了一项研究，分别涉及患者入组研究、早期干预服务、儿童发育、血压降低和控制以及营养饮食习惯等领域。尽管研究之间存在显着的异质性，无法进行数据汇总和荟萃分析，现有随机对照试验证据的权重表明，在美国使用CHW干预策略可能会产生积极的益处。卫生保健设置。
BACKGROUND: There is increasing concern about racial and ethnic disparities in health status and health care in the United States (U.S.). Recent recommendations to address these disparities have encouraged the use of community health workers (CHWs) as a promising intervention.OBJECTIVES: The purpose of this review is to provide a systematic examination of randomized controlled trial (RCT) evidence regarding the usefulness of CHWs in the U.S. health care system.METHODS: We searched electronic databases from January 1, 1990, to June 7, 2007, to identify RCTs using CHWs. Two researchers systematically reviewed all eligible articles. Data were extracted from each eligible study and independently reviewed by both investigators.RESULTS: Twelve studies were eligible for inclusion in this review. Of those 12 studies, 10 demonstrated CHW efficacy in enhancing outcomes. Three of these studies addressed breast cancer screening behaviors and three evaluated Pap smear testing. The review found one study each in the areas of patient enrollment in research, early intervention services, child development, blood pressure reduction and control, and nutritional eating habits.CONCLUSIONS: Although significant heterogeneity among studies precluded pooling of data and meta-analyses, the weight of the available RCT evidence suggests positive benefits may be attributable to the use of CHWs interventional strategy in the context of the U.S. health care setting.