Effectiveness of community health workers in traditional and emerging roles: A systematic review

The utilization of community health workers (CHWs) in public health and other fields has grown increasingly in recent years. Traditional CHW health outreach, education, and promotion roles include: 1) interpretation/translation services; 2) culturally appropriate health education; 3) assess clients' needs; 4) assist clients in accessing services; 5) eligibility screenings; 6) informal counseling on health behaviors; 7) arrange transportation; 8) advocate for individual and community needs; 9) provide some direct services; 10) offer emotional support; 11) refer clients to services; and 12) maintain client records. Emerging public health research roles of CHWs include: 1) IRB training/submission; 2) obtain consent; 3) protocol and training development; 4) instrument development and validation; 5) training in ethnographic methodologies; 6) recruit participants and conduct focus groups and key leader interviews; 7) data collection/entry; 8) participant observation; 9) write detailed field notes/reports; 10) administer instruments; 11) manuscript development; and 12) present/disseminate findings. The purpose of this systematic review was to evaluate the effectiveness of community health workers in these traditional and emerging roles. Methods for this review included: 1) eligibility criteria for selecting studies for this review; 2) information sources for identifying studies; 3) data collection and analytic strategies; 4) results (description of studies; bias; effects of studies); 5) discussion; and 6) conclusions. The significance of this study lies in its contribution to the literature in terms of the effectiveness of CHWs in traditional and emerging roles across multiple domains—cultural relevance, community based participatory research; vulnerable and minority populations; social support; and behavioral change—particularly among Hispanic populations.