Jean L. Raphael|Anna Rueda|K. Casey Lion|Thomas P. Giordano
The Role of Lay Health Workers in Pediatric Chronic Disease: A Systematic Review
Baylor College of Medicine|Baylor College of Medicine|University of Washington|Baylor College of Medicine
h2abstracth2h3backgroundh3 children chronic diseases represent highcost resourceintensive population children continued gaps chronic disease management persistent fragmentation health care system stakeholders seeking new strategies address needs children h3objectiveh3 sought systematically assess effectiveness lay health worker interventions improving health care utilization symptom management family psychosocial outcomes children chronic conditions h3data sourceh3 pubmed psycinfo web science january 1961 february 2013 h3study eligibility criteria participants interventionsh3 developed strategy search citations identify relevant articles search terms included randomized controlled trial rct lay worker parent mentor peer mentor peer educator community health workers community health aids patient advocate patient facilitator patient liaison promotorases care ambassadors patient navigator nonprofessional additional studies identified searching reference lists retrieved articles contacting clinical experts rcts lay health worker interventions children chronic conditions included studies restricted concentrated children 018 years age chronic illnesses h3study appraisal synthesis methodsh3 abstracts independently screened 2 reviewers articles relevant abstracts underwent full text review evaluated inclusion criteria structured tool used abstract data selected articles heterogeneous interventions outcomes conduct metaanalysis h3resultsh3 search yielded 736 unique articles 17 met inclusion criteria interventions focused specific conditions asthma type diabetes obesity failure thrive interventions heterogeneous frequency mode duration interactions lay health workers subjects several interventions multifaceted including oneonone group interactions improved outcomes commonly reported reduced urgent care use decreases symptoms fewer missed work school days increased parental quality life one study demonstrated lay health worker interventions costeffective h3conclusionsh3 lay health workers interventions children chronic conditions may lead modest improvements urgent care use symptoms parental psychosocial outcomes interventions may also costeffective future research focus interventions targeted toward chronic conditions sickle cell disease cystic fibrosis medically complex children whose conditions noncategorical