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Area of Science:

  • Public Health
  • Health Services Research
  • Health Equity

Background:

  • Community health workers (CHWs) are vital for connecting underserved populations to health and social services.
  • CHWs possess local insights crucial for reducing information gaps and addressing health-related social needs.
  • Previous reviews lacked focus on rigorous evidence from randomized control trials (RCTs) and organizational settings.

Purpose of the Study:

  • To conduct a scoping review of RCT studies on CHW interventions in the US from 2000-2023.
  • To analyze CHW interventions based on the employing organization type.
  • To assess the quality of evidence for CHW effectiveness across different settings.

Main Methods:

  • Scoping review of US-based peer-reviewed literature (2000-2023).
  • Inclusion criteria focused on randomized control trial (RCT) studies of CHW interventions.
  • Analysis categorized studies by organizational setting (e.g., health care systems, public health agencies, payers).

Main Results:

  • 39 RCT studies met inclusion criteria, with most conducted in health care systems and community health centers.
  • Few rigorous RCTs were identified in public health agencies or managed care organizations.
  • Consistent evidence of improved patient outcomes was found across most CHW intervention studies.

Conclusions:

  • Health care organizations can leverage CHWs to address resource gaps and improve patient care.
  • Further RCTs are needed for CHWs employed by public health agencies and health plans to strengthen evidence.
  • CHWs demonstrate effectiveness in improving patient outcomes across diverse organizational contexts.