Evaluating the effectiveness of community health worker interventions on glycaemic control in type 2 diabetes mellitus: a systematic review and meta-analysis

Objective Community health worker (CHW) interventions in control of HbA1c levels in diabetes have shown varied effects in randomised controlled trials. In the systematic review reported here, we aimed to evaluate the independent effectiveness of CHW interventions on the control of HbA1c levels in ad...

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Main Authors: Joseph Evans, Howard Ha, Patrick Thomas White
Format: Article
Language:English
Published: BMJ Publishing Group 2025-07-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/7/e096651.full
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author Joseph Evans
Howard Ha
Patrick Thomas White
author_facet Joseph Evans
Howard Ha
Patrick Thomas White
author_sort Joseph Evans
collection DOAJ
description Objective Community health worker (CHW) interventions in control of HbA1c levels in diabetes have shown varied effects in randomised controlled trials. In the systematic review reported here, we aimed to evaluate the independent effectiveness of CHW interventions on the control of HbA1c levels in adults with type 2 diabetes.Design Systematic review and meta-analysis.Participants 1684 participants from 7 studies were included.Interventions Randomised controlled trials of adults with type 2 diabetes receiving CHW interventions of at least 12 months’ duration compared with usual care were eligible. Databases searched were Ovid MEDLINE, the Cochrane Central Register, CINAHL and Web of Science from 2000 to March 2025. Quality was assessed using the Cochrane RoB2 tool.Primary outcome measure Through meta-analysis, we calculated the mean weighted difference (MWD) of change in HbA1c level from baseline between groups using RevMan.Results Seven of 86 retrieved studies were eligible. Six studies were suitable for meta-analysis and included 1280 participants. An inverse variance weighted meta-analysis showed a significant improvement in pooled HbA1c level with an MWD of 0.50% (0.28%, 0.71%) in the CHW group (p<0.0001). Outcome heterogeneity was low (I2=21%), and the overall level of certainty was high.Conclusions CHW interventions in type 2 diabetes showed statistically significant and clinically important reductions in HbA1c levels in people from minority ethnic groups on low income.
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spelling doaj-art-77d85fb93a3244eaa0c0cc270c3495e22025-08-20T03:27:56ZengBMJ Publishing GroupBMJ Open2044-60552025-07-0115710.1136/bmjopen-2024-096651Evaluating the effectiveness of community health worker interventions on glycaemic control in type 2 diabetes mellitus: a systematic review and meta-analysisJoseph Evans0Howard Ha1Patrick Thomas White2Population Health Sciences, King’s College London Faculty of Life Sciences & Medicine, London, UKPopulation Health Sciences, King’s College London Faculty of Life Sciences & Medicine, London, UKPopulation Health Sciences, King’s College London Faculty of Life Sciences & Medicine, London, UKObjective Community health worker (CHW) interventions in control of HbA1c levels in diabetes have shown varied effects in randomised controlled trials. In the systematic review reported here, we aimed to evaluate the independent effectiveness of CHW interventions on the control of HbA1c levels in adults with type 2 diabetes.Design Systematic review and meta-analysis.Participants 1684 participants from 7 studies were included.Interventions Randomised controlled trials of adults with type 2 diabetes receiving CHW interventions of at least 12 months’ duration compared with usual care were eligible. Databases searched were Ovid MEDLINE, the Cochrane Central Register, CINAHL and Web of Science from 2000 to March 2025. Quality was assessed using the Cochrane RoB2 tool.Primary outcome measure Through meta-analysis, we calculated the mean weighted difference (MWD) of change in HbA1c level from baseline between groups using RevMan.Results Seven of 86 retrieved studies were eligible. Six studies were suitable for meta-analysis and included 1280 participants. An inverse variance weighted meta-analysis showed a significant improvement in pooled HbA1c level with an MWD of 0.50% (0.28%, 0.71%) in the CHW group (p<0.0001). Outcome heterogeneity was low (I2=21%), and the overall level of certainty was high.Conclusions CHW interventions in type 2 diabetes showed statistically significant and clinically important reductions in HbA1c levels in people from minority ethnic groups on low income.https://bmjopen.bmj.com/content/15/7/e096651.full
spellingShingle Joseph Evans
Howard Ha
Patrick Thomas White
Evaluating the effectiveness of community health worker interventions on glycaemic control in type 2 diabetes mellitus: a systematic review and meta-analysis
BMJ Open
title Evaluating the effectiveness of community health worker interventions on glycaemic control in type 2 diabetes mellitus: a systematic review and meta-analysis
title_full Evaluating the effectiveness of community health worker interventions on glycaemic control in type 2 diabetes mellitus: a systematic review and meta-analysis
title_fullStr Evaluating the effectiveness of community health worker interventions on glycaemic control in type 2 diabetes mellitus: a systematic review and meta-analysis
title_full_unstemmed Evaluating the effectiveness of community health worker interventions on glycaemic control in type 2 diabetes mellitus: a systematic review and meta-analysis
title_short Evaluating the effectiveness of community health worker interventions on glycaemic control in type 2 diabetes mellitus: a systematic review and meta-analysis
title_sort evaluating the effectiveness of community health worker interventions on glycaemic control in type 2 diabetes mellitus a systematic review and meta analysis
url https://bmjopen.bmj.com/content/15/7/e096651.full
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