Community health worker interventions to improve access to health care services for older adults from ethnic minorities: a systematic review.
Community health worker interventions to improve access to health care services for older adults from ethnic minorities: a systematic review.
复制标题
DOI：
10.1186/s12913-014-0497-1
复制
发表时间：
2014-11-13
影响因子：
2.8
通讯作者：
Ros WJ
中科院分区：
文献类型：
--
作者：
Verhagen I;Steunenberg B;de Wit NJ;Ros WJ
在西方国家，属于少数民族的老年人的健康状况是一个重要的公共问题，因为他们的健康状况往往不如多数人口中的老年人。此外，在西方国家，属于少数民族的老年人人数正在迅速增加。引入社区卫生工作者（CHW）已被证明是成功的，在解决少数民族之间的健康差距，但是，在文献中没有CHW的老年人的好处的概述。我们回顾了文献，探讨CHW是否也有效地改善健康和提供医疗保健服务的少数民族老年人在西方国家。我们检索了PubMed数据库（2002年至今）中关于西方国家使用CHW的RCT。在确定的729项研究中，有7项研究符合我们的纳入标准。在少数民族老年人中实施社区保健方案的效果并非是显而易见的。在两项研究中，我们没有发现显著差异。在五项研究中，我们发现了一些积极的影响。我们在任何研究中都没有发现负面影响。为了更好地解释结果，将效应比（ER）计算为阳性结果的数量除以测量结果的总数。获得护理（平均ER = 0.58）和健康行为（平均ER = 0.45）的实质性影响被发现。我们发现有迹象表明，社区卫生工作者作为一种手段，改善医疗保健的使用和健康行为，并在较小程度上，少数民族老年人的健康结果。需要进一步研究，以得出更坚实的结论，在这一目标群体的CHW干预措施的有效性。这对西方国家尤为重要，因为在这些国家，少数族裔老年人的人数大幅增加，因为他们的健康状况大多不利，获得保健服务的机会往往有限。本文的在线版本（doi：10.1186/s12913-014-0497-1）包含补充材料，可供授权用户使用。
The health status of older adults belonging to ethnic minorities in Western countries is an important public issue because their health is often less favourable than that of older adults from the majority population. In addition, the number of older adults belonging to ethnic minorities is increasing rapidly in Western countries. The introduction of community health workers (CHWs) has proven to be successful in addressing health disparities among ethnic minorities; however, an overview of CHW’s benefits for older adults is absent in the literature. We reviewed the literature to explore whether CHWs are also effective in improving the health and the delivery of health care services to ethnic minority older adults in Western countries. We searched the PubMed database (2002-Present) for RCTs published on the use of CHWs in Western countries. Out of the 729 studies identified, seven studies met our inclusion criteria. The effectiveness of the implementation of CHW programmes in older adults belonging to ethnic minorities is not univocal. In two studies, we found no significant differences. In five studies, we found some positive effects. We did not find negative effects in any of the studies. For better interpretation of the results, effect ratios (ERs) were calculated as the number of positive findings divided by the total number of measured findings. Substantial effects on the access to care (mean ER = 0.58) and on health behaviour (mean ER = 0.45) were found. The mean ER for health outcomes was considerably lower (mean ER = 0.17). We found indications that CHWs serve as a means of improving health care use and health behaviour and, to a lesser extent, health outcomes among ethnic minority older adults. Further research is required to draw more solid conclusions on the effectiveness of CHW interventions in this target group. This is particularly important for Western countries in which the number of ethnic minority older adults has increased significantly because their health status is mostly unfavourable and their access to health care services is often limited. The online version of this article (doi:10.1186/s12913-014-0497-1) contains supplementary material, which is available to authorized users.