Patrick M Newman|Molly F Franke|Jafet Arrieta|Héctor Carrasco|Patrick Elliott|Hugo Flores|Alexandra Friedman|Sophia Graham|Luis Martínez|Lindsay Palazuelos|Kevin Savage|Hayley Tymeson|Daniel Palazuelos
Community health workers improve disease control and medication adherence among patients with diabetes and/or hypertension in Chiapas, Mexico: an observational stepped-wedge study
University of California, San Francisco|Harvard University|Harvard University|Harvard University|Brigham and Women's Hospital|University of Global Health Equity|University of California, San Francisco|London School of Hygiene & Tropical Medicine|Partners In Health|Harvard University|University of Washington|Institute for Health Metrics and Evaluation
noncommunicable diseases ncds contribute greatly morbidity mortality lowincome middleincome countries lmics community health workers chws may improve disease control medication adherence among patients ncds lmics data lacking assessed impact chwled intervention disease control adherence among patients diabetes andor hypertension chiapas mexicowe conducted prospective observational study among adult patients diabetes andor hypertension context steppedwedge rollout chwled intervention measured selfreported adherence medications blood pressure haemoglobin a1c baseline every 3 months timed prior expansion intervention new community conducted individuallevel mixed effects analyses study data adjusting time clustering patient communitywe analysed 108 patients chwled intervention associated twofold increase odds disease control 204 95 ci 115 362 also associated optimal adherence assessed 30day recall 186 95 ci 115 302 positive selfassessment adherence behaviour 229 95 ci 126 415 5day recalla chwled adherence intervention associated disease control adherence among adults diabetes andor hypertension study supports role chws supplementing comprehensive primary care patients ncds lmicsnct02549495