Table 2.
Description of Included Studies
| Intervention | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Citation | Study design | Number and description of participants | Funding source* | Pediatric/adult | Chronic disease | Healthcare use for inclusion (yes/no) | Insurance status/income status for inclusion (yes/no) | Location (urban or rural; state) | Duration | Setting | Intens-ity† | CHW part of care team? (if yes, description) | Brief description of CHW role‡ |
| Babamoto et al. 200933 | RCT | 318 Hispanic/Latino |
Private foundation; for-profit company | Adult | Type II diabetes | No | None | Urban; CA | 6 months | Community, home, clinic, telephone | NS, NS, 6, 3 | No | Health coaching, health education§ |
| Bryant-Stephens and Li 200835 | RCT | 281 99% African American |
Not stated | Pediatric | Asthma | Yes (≥1 hospitalization for asthma or ≥2 asthma-related emergency visits 1 year before enrollment) | None | Urban; PA | 1 year | Home | 5, NS, 12,1 | No | Home visiting, environmental modification, health education |
| Fisher et al. 200936 | RCT | 191 Predominantly African American area |
State or federal; private foundation; other non-profit organization | Pediatric, adult | Asthma | Yes (hospitalized for asthma) | Yes (Medicaid) | Urban; MS | April 1997–Feb. 1999 | Hospital, home | NS, NS, 24, 1 | No | Home visiting, health coaching, health education |
| Gary et al. 200937 | RCT | 542 African American |
State or federal | Adult | Type II diabetes | No | None | Urban; MD | 24 months | None stated | NS, NS, 24, 1 | Yes (CHW works with nurse case manager to deliver intervention) | Health education, health coaching, home visiting, advocacy, care coordination |
| Hopper et al. 198438 | RCT | 227 77% Black |
State or federal | Adult | Type II diabetes | Yes (regular clinic attendance in 1978) | None | Urban; MS | 18 months | Hospital | NS, NS, 18, 1 | No | Health coaching, health education, home visiting |
| Hunter et al. 200461 | RCT | 101 96% Hispanic |
Not stated | Adult | None | Yes (participated in an initial clinical screening exam) | None | Rural; AZ | 1 year | Home | NS, NS, NS, 1 | No | Home visiting, connecting with health services, health education§ |
| Kangovi et al. 201451 | RCT | 446 93% Black |
Academic institution; healthcare provider | Adult | None | Yes (admitted to a medicine service and expected to be discharged home, as opposed to an acute care facility) | Uninsured or Medicaid and resident of a specified zip code (>30% of residents live below the federal poverty line) | Urban; PA | April 2011–Dec. 2012 | Hospital | NS, NS, 0.5, 1 | No | Health coaching, advocacy, home visiting, connecting with health services, care coordination |
| Krieger et al. 199960 | RCT | 421 79.1% Black |
State or federal | Adult | Elevated blood pressure | No | Yes (<200% of the 1995 federal poverty level) | Urban; WA | 3 months | Home, community sites and centers | NS, NS, NS, 1 | No | Connecting with health services, connecting with social services |
| Krieger et al. 200555 | RCT | 274 12.3% Non-Hispanic White, 31.9% Non-Hispanic African American, 25.4% Vietnamese, 9.4% other Asian, 17.4% Hispanic, 2.6% other |
State or federal; private foundation | Pediatric | Asthma | Yes (prior provider asthma diagnosis per outpatient record or 1 ED discharge with asthma as primary diagnosis) | Yes (<200% of the 1996 federal poverty level) | Urban; WA | 1 year | Home | 5–9, NS, 12, 1 | No | Home visiting, health coaching, health education, environmental modification, connecting to social services§ |
| Krieger et al. 201554 | RCT | 366 46.7% Hispanic |
State or federal | Adult | Asthma | Yes (previous clinical diagnosis) | Yes (<250% of the 2007 federal poverty level) | Urban; WA | 1 year | Home | 5, NS, 7, 1 | No | Health education, home visiting, health coaching, advocacy, connecting with social services, environmental modification, care coordination§ |
| Kronish et al. 201457 | RCT | 600 40% Black, 42% Latino, 13% White, 4% other |
State or federal | Adult | Stroke/“mini-stroke” | Yes (prior treatment for stroke) | None | Urban; NY | 6 months | Community center | 6, 90, 6, 3 | No | Health education, health coaching |
| Martin et al. 201459 | RCT | 101 Hispanic predominantly Puerto Rican |
State or federal | Pediatric | Asthma | Yes (prescribed ICS in past year) | None | Urban; IL | 4 months | Home | 4, NS, 12, 1 | No | Home visiting, health education, health coaching |
| Nelson et al. 201139 | RCT | 247 94% African American, 4.2% White, 1.6% other |
State or federal | Pediatric | Asthma | Yes (ED visit for acute asthma care in preceding 15 months OR primary care diagnosis) | Yes (Medicaid) | Urban; MS | 18 months | Hospital | ≥18, NS, 18, 1 | No | Health coaching, home visiting |
| Parker et al. 200853 | RCT | 328 83% African American, 11% Hispanic, 4% Caucasian, 3% other |
State or federal | Pediatric | Asthma | Yes (doctor prescribed medicine for respiratory symptoms) | None | Urban; MI | 1 year | Home | 9, NS, 12, 1 | No | Connecting with social services, home visiting, connecting with health services, health coaching, environmental modification, health education§ |
| Rothschild et al. 201456 | RCT | 144 Mexican Americans |
State or federal | Adult | Type II diabetes | No | Yes (health insurance or receive care through free clinic) | Urban; IL | 2 years | Home, hospital | 36, 99 avg, 24, 1 | No | Home visiting, health education§ |
| Wang et al. 201234 | RCT | 200 Post incarceration (5.2% Asian, 63.4% Black, 10.4% Hispanic, 20.8% White) |
Private foundation; local government | Adult | At least one chronic illness | No | None | Urban; CA | 1 year | Primary care center | NS, NS, NS, 1 | Yes (CHWs works closely with primary care provider) | Connecting with social services, connecting with health services, home visiting, health education |
| Adair et al. 201247 | Pre-post | 332 43% Black, 49% White, 8% other |
Private foundation | Adult | Hypertension, diabetes, or heart failure | No | None | Urban; MN | 1 year | Primary care center | NS, NS, NS, 1 | No | Health education, care coordination, health coaching, advocacy |
| Ferrer et al. 201348 | Pre-post | 1,500 Hispanic |
Academic institution | Adult | High-risk patients | No | None | Rural; TX | 1 year | Primary care center, community | NS, NS, NS, 3 | Yes (CHWs participate in group visits with team) | Home visiting, care coordination, advocacy, health coaching, health education§ |
| Fox et al. 200745 | Pre-post | 541 14.3% Black, 81.7% Hispanic, 2.2% White |
Private foundation | Pediatric | Asthma | No | Yes (low income) | Urban; CA | 2001–2004 | Primary care center, home | NS, NS, 24, 1 | Yes (CHWs help connect providers to coordinate care and participate in team quality improvement) | Care coordination, health education, connecting with social services, home visiting |
| Margellos-Anast et al. 201241 | Pre-post | 70 Non-Hispanic Black |
State or federal | Pediatric | Asthma | Yes (ED visit or hospitalization in past year) | Yes (low income) | Urban; IL | 6 months | Home | 3–4, NS, 6, 1 | No | Home visiting, health education, connecting with health services, care coordination |
| Michelen et al. 200642 | Pre-post | 711 92% Hispanic, <6% African American, other |
Not stated | Pediatric | None | Yes (3 or more ED utilizations in past 6 months) | None | Urban; NY | 6 months | Home | NS, NS, NS, 1 | No | Care coordination, health education§ |
| Postma et al. 201143 | Pre-post | 866 91% Hispanic, 9% Non-Hispanic |
State or federal; academic institution | Pediatric | Asthma | No | None | Rural; WA | 8 months | Home | 8, NS, 8, 1 | No | Home visiting, health education, health coaching, environmental modification, connecting with social services, connecting with health services |
| Primomo et al. 200646 | Pre-post | 105 68% Caucasian, 19% African American, 5% Samoan, 3% Hispanic, 3% Native American, 3% Chinese, 2% other |
State or federal; academic institution | Pediatric | Asthma | No | None | WA | 2-26 weeks | Home | 2.24 avg, NS, 5 weeks avg, 1 | No | Home visiting, health coaching, health education, environmental modification, advocacy |
| Turyk et al. 201344 | Pre-post | 300 African American |
Private foundation | Pediatric | Asthma | No | Yes (low income) | Urban; IL | 1 year | Home | 6, NS, 12, 1 | No | Home visiting, health education, health coaching, care coordination, environmental modification, connecting with social services, connecting with health services |
| Bryant-Stephens et al. 200949 | Cohort | 264 98% Non-Hispanic Black |
State or federal | Pediatric | Asthma | Yes (≥1 hospitalization due to asthma or ≥2 asthma-related emergency visits 1 year before the time of enrollment) | None | Urban; PA | 1 year | Home | 5, NS, 6, 1 | No | Home visiting, health education, environmental modification |
| Enard and Ganelin 201350 | Cohort | 13,642 15.7% White, 58% Black, 23.1% Hispanic, 2.2% other |
Private foundation; state or federal | Pediatric, adult | None | Yes (at least one “primary-care related” ED use) | None | Urban; TX | 12 months | Hospital, telephone | NS, NS, 24, 1 | No | Health education, connecting with health services, advocacy§ |
| Felix et al. 201152 | Cohort | 2,122 76.9% Black |
Private foundation; state or federal | Adult | Long-term care needs | No | None | Rural; AR | 3 years | Home, community | NS, NS, NS, 1 | No | Connecting patients to social services, advocacy, health education |
| Freeborn et al. 197862 | Cohort | 6,159 No stated description |
State or federal | Pediatric, adult | None | No | Yes: Kaiser Permanente and low income | Urban; OR | Not stated | Primary care center | NS, NS, 12, 1 | Yes (CHWs work with patients during clinic visits) | Health education, connecting with social services |
| Johnson et al. 20125 | Cohort | 448 No stated description |
Private foundation | Adult | None | Yes (3 or more ED visits in one quarter) | Yes (Molina Healthcare of New Mexico) | Urban and rural; NM | 25 months | Not stated | NS, NS, 25, NS | Yes (CHW member of care team and coordinate between providers) | Home visiting, health coaching, health education, advocacy, connecting with health services, connecting with social services |
| Roth et al. 201258 | Cohort | 449 28.9% Black, 65.7% White, 5.4% Other |
State or federal | Adult | HIV-positive | No | Yes (Health Insurance Assistance Program) | Urban; IN | 1 year | Not stated | NS, NS, 12, 1 | No | Health education |
| Brown et al. 201263 | Cost-effect | 46 Hispanic |
State or federal | Adult | Type II diabetes | No | None | Urban; TX | 18 months | Primary care center, home | NS, NS, NS, 2 | Yes (CHW works with nurse practitioner) | Home visiting, health education, health coaching§ |
| Kattan et al. 200540 | Cost-effect | 937 No stated description |
State or federal | Pediatric | Asthma | Yes (at least one hospitalization and 2 unscheduled asthma visits in the 6 months before enrollment) | None | Urban; MA, NY, IL, TX, WA, AZ | 2 years | Home | NS, NS, 24, 1 | No | Home visiting, environmental modification |
| Mirambeau et al. 201330 | Cost-effect | Not stated Not stated |
State or federal; insurance provider; healthcare provider | Adult | Not stated | Yes (patient at the Northeastern Vermont Regional Hospital) | None | Rural; VT | Not stated | Hospital | NS, NS, NS, NS | No | Connecting with social services, care coordination, connecting to health services, health coaching |
| Ryabov 201464 | Cost-effect | 30 Hispanic |
Not stated | Adult | Type II diabetes | No | Yes (low income) | Rural; TX | 2 years | Primary care center | 24, NS, 24, 1 | No | Home visiting, health education, health coaching |
*We reported funding sources as one or more of seven types: private foundation, insurance provider, state or federal, healthcare provider, academic institution, local government, or other non-profit organization
†Intensity: number of visits, average length of visits (min), intervention length months, all group visits = 3, mixed group/one on one = 2, only one on one = 1, NS = Not stated
‡To describe the CHW role, we categorized CHW roles into eight groups: connecting patients with social service, care coordination, connecting patients to health services, health coaching, home visiting, environmental modification, advocacy, and health education. We assigned one or more of these labels to each study to capture all of the activities that the CHWs performed
§Community health workers were explicitly reported as bilingual