Community health worker interventions to improve access to health care services for older adults from ethnic minorities: a systematic review

BMC Health Services Research

Wynand JG Ros¹  Niek J de Wit¹  Bas Steunenberg¹  Ilona Verhagen¹ 

[1]Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Mailbox 85500, Utrecht, 3508, GA, The Netherlands

关键词: Systematic review;    Access to health care;    Ethnic minority older adults;    Community health worker;   

Others  :  1092082
DOI  :  10.1186/s12913-014-0497-1

 received in 2013-12-06, accepted in 2014-10-06,  发布年份 2014

【 摘 要 】

Background

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.

Methods

We searched the PubMed database (2002-Present) for RCTs published on the use of CHWs in Western countries.

Results

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).

Conclusion

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.

【 授权许可】

   
2014 Verhagen et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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