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Community health workers involvement in preventative care in primary healthcare: a systematic scoping review
  1. Nila Sharma,
  2. Elizabeth Harris,
  3. Jane Lloyd,
  4. Sabuj Kanti Mistry,
  5. Mark Harris
  1. Centre for Primary Health Care and Equity, University of New South Wales, Sydney, New South Wales, Australia
  1. Correspondence to Professor Mark Harris; m.f.harris{at}unsw.edu.au

Abstract

Objectives To review effective models of community health worker (CHW) involvement in preventive care for disadvantaged culturally and linguistically diverse (CALD) patients in primary healthcare (PHC) that may be applicable to the Australian context.

Design Systematic scoping review.

Data sources The studies were gathered through searching Medline, EMBASE, EMCARE, PsycINFO, CINAHL and online portals of relevant organisations.

Eligibility criteria All selected studies were original research studies which essentially evaluated preventive intervention undertake by CHWs in PHC. The intervened population were adults with or without diagnosed chronic health disease, culturally and linguistically diverse, or vulnerable due to geographic, economic and/or cultural characteristics that impede or compromise their access to healthcare.

Data extraction and synthesis Data extraction was undertaken systematically in an excel spreadsheet while the findings were synthesised in a narrative manner. The quality appraisal of the selected studies was performed using effective public health practice project quality assessment tool.

Results A total of 1066 articles were identified during the initial search of six bibliographic databases. After screening the title, abstract and full text, 37 articles met the selection and methodological criteria and underwent data extraction. A high-quality evidence-base supporting the positive impact of CHWs supporting patients’ access to healthcare and influencing positive behaviour change was found. Positive impacts of CHW interventions included improvements in clinical disease indicators, screening rates and behavioural change. Education-focused interventions were more effective in improving patient behaviour, whereas navigation interventions were most effective in improving access to services. Implementation was enhanced by cultural and linguistic congruence and specific training of CHWs in the intervention but reduced by short duration interventions, dropouts and poor adherence of patients.

Conclusion The evidence generated from this systematic scoping review demonstrates the contribution of CHWs to improving access to preventive care for patients from CALD and disadvantaged backgrounds by providing both education and navigational interventions. More research is needed on CHW training and the incorporation of CHWs into primary health care (PHC) teams.

  • community health workers
  • preventive medicine
  • primary care
  • disadvantaged populations
  • culturally and linguistically diverse population

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • Contributors NS contributed to the design of the review, designed and conducted the search, adjudicated and appraised studies, extracted and analysed data and drafted the manuscript. MH coordinated and designed the review, conducted the search, appraised studies, extracted and analysed data and reviewed the manuscript. EH and JL contributed to the design of the review, adjudicated and appraised studies, reviewed and analysed data and reviewed the manuscript. SKM updated the original search for 2018/2019 and revised the manuscript. All authors read and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.

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