Thomas A. Gaziano|Shafika Abrahams?Gessel|Catalina Denman|Carlos Mendoza Montano|Masuma Akter Khanam|Thandi Puoane|Naomi Levitt
An assessment of community health workers' ability to screen for cardiovascular disease risk with a simple, non-invasive risk assessment instrument in Bangladesh, Guatemala, Mexico, and South Africa: an observational study
Brigham and Women's Hospital|El Colegio de Sonora|Institute of Nutrition of Central America and Panama|International Centre for Diarrhoeal Disease Research|University of the Western Cape|University of Cape Town
cardiovascular disease contributes substantially noncommunicable disease ncd burden lowincome middleincome countries also often substantial health personnel shortages observational study investigated whether community health workers could communitybased screenings predict cardiovascular disease risk effectively could physicians nurses simple noninvasive risk prediction indicator lowincome middleincome countriesthis observation study done bangladesh guatemala mexico south africa site recruited least ten 15 community health workers based usual sitespecific norms required levels education language competency community health workers reside community screenings done fluent communitys predominant language workers trained calculate absolute cardiovascular disease risk score previously validated simple noninvasive screening indicator community health workers successfully finished training screened community residents aged 3574 years without previous diagnosis hypertension diabetes heart disease health professionals independently generated second risk score instrument two sets scores compared agreement primary endpoint study level direct agreement risk scores assigned community health workers health professionalsof 68 community health worker trainees recruited june 4 2012 feb 8 2013 42 deemed qualified fieldwork 15 bangladesh eight guatemala nine mexico ten south africa across sites 4383 community members approached participation 4049 completed screening mean level agreement two sets risk scores 968 weighted 0948 95 ci 09360961 community health workers showed 263 6 4049 people 5year cardiovascular disease risk greater 20health workers without formal professional training adequately trained effectively screen identify people high risk cardiovascular disease using community health workers screening would free trained health professionals lowresource settings tasks need high levels formal professional training