Systematic review of U.S.-based randomized controlled trials using community health workers.

M. Christopher Gibbons, Nadra C. Tyus

Research output: Contribution to journalReview articlepeer-review

59 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)371-381
Number of pages11
JournalProgress in community health partnerships : research, education, and action
Issue number4
StatePublished - 2007
Externally publishedYes

ASJC Scopus subject areas

  • Health(social science)
  • Education
  • Sociology and Political Science


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