Community Health Workers in Schools: A Systematic Review

Abstract

Background: Community health workers (CHWs) are trusted community members who provide health education and care. However, no consensus exists regarding whether community health worker-based interventions are effective within the school setting.

Objective: To determine outcomes and best practices of school-based community health worker interventions.

Data sources: PubMed, CINAHL, and SCOPUS databases.

Study eligibility criteria: This systematic literature review examined articles that described an intervention led by community health workers, targeted children and/or parents, and took place primarily within a Kindergarten-12^th grade school setting. Articles were excluded if they described an intervention outside the United States.

Participants: Community health workers, children, and/or their parents INTERVENTIONS: School-based community health worker programs RESULTS: Of 1875 articles identified, 13 met inclusion criteria and were included in the final analysis. Of these, 5 described a statistically significant primary outcome. Seven articles provided details regarding community health worker recruitment, training, and roles that would enable reproduction of the intervention.

Limitations: This review focused on interventions in the United States. Bias of individual studies had a wide range of scores (9-21). Heterogeneity of studies also precluded a meta-analysis of primary outcomes.

Conclusions and implications of key findings: The utilization of Community health workers in school-based interventions for children and/or parents is promising. This review identified a lack of detail and uniformity in program presentation, specifically with Community health worker recruitment, training, and roles. A standardized reporting mechanism for Community health worker interventions in schools would better allow for reproducibility and scalability of existing studies.

Keywords: children; community health workers; schools.

FIGURE 1:. PRISMA Diagram

*Reasons for exclusion included: not U.S. based, articles not in English, non-CHW intervention, intervention not in school or the intervention did not target children or parents. Many articles met multiple exlusionary criteria.