Abstract
BackgroundThe 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.MethodsWe searched the PubMed database (2002-Present) for RCTs published on the use of CHWs in Western countries.ResultsOut 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).ConclusionWe 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.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-014-0497-1) contains supplementary material, which is available to authorized users.
Highlights
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
Limited access to health care services has been reported to be an important factor for these disparities in health [6,7] and is in part caused by limited knowledge about health care facilities
We aimed to investigate whether community health workers (CHWs) are effective in providing the aforementioned benefits to ethnic minority older adults
Summary
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. The introduction of community health workers (CHWs) has proven to be successful in addressing health disparities among ethnic minorities; an overview of CHW’s benefits for older adults is absent in the literature. We reviewed the literature to explore whether CHWs are effective in improving the health and the delivery of health care services to ethnic minority older adults in Western countries. CHWs share the same ethnic background, speak the same language, are aware of the health beliefs and understand the barriers to health care that ethnic minority adults experience. They act as intermediaries between community members and providers of health care services [10,11]. CHWs work in various functions: to improve health knowledge, to increase access to health care, to induce behavioural changes, and to reduce health care costs [13]
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