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September 12, 2019Global HeartOpen Access

The intervention significantly reduced systolic blood pressure by an adjusted difference of -8.9 mm Hg (95% CI: -3.5 to -14.4 mm Hg; p = 0.001) compared to usual care, but had no significant effect on fasting blood glucose or smoking.

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Why the study?

Most premature cardiovascular mortality occurs in low- and middle-income countries, driven primarily by hypertension, diabetes, and smoking.

Does behavioral change communication through community health workers improve systolic blood pressure, fasting blood glucose, and smoking rates in adults with cardiovascular risk factors?

Population

1,242 adults aged 35 to 70 with at least 1 risk factor in India

Comparison

CHW behavioral change home visits vs usual care

Design

Cluster randomized controlled trial

Follow-up

2 years

Authors

AKAditya KhetanMZMelissa D. ZulloARAnitha Rani

Discussion

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Member takes

Overview

CHW-led integrated care improves hypertension control in LMICs; extends single-risk-factor CHW evidence to multicondition management.

Structured PICO

Does behavioral change communication through community health workers improve systolic blood pressure, fasting blood glucose, and smoking rates in adults with cardiovascular risk factors?

P
Population
1,242 adults (35 to 70 years of age) with at least 1 cardiovascular risk factor (hypertension n=650, diabetes n=317, smoking n=500) from a single town in India.
I
Intervention
Behavioral change communication through regular home visits from community health workers over 2 years.
C
Comparator
Usual care in the community.
O
Outcome
Changes in systolic blood pressure, fasting blood glucose, and average number of cigarettes/bidis smoked daily among individuals with respective risk factors at 2 years.surrogate

A community health worker-based approach using behavioral change communication significantly improved systolic blood pressure control but not glycemic control or smoking cessation in a low-resource setting.

Cite This Study

Khetan et al. (2019) studied this question.

synapsesocial.com/papers/6a714dc4e5469ee92be1e033https://doi.org/10.1016/j.gheart.2019.08.003
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Community health worker-led interventions for cardio-metabolic diseases in India: Evidence from a systematic review and meta-analysis2026
  2. 2Feasibility of Community Health Worker based cardiovascular risk reduction strategies in urban slums of Bhopal: Rationale, design and baseline results of community based study2020 · 8 citations
  3. 3Preliminary efficacy of a community health worker homebased intervention for the control and management of hypertension in Kiambu County, Kenya- A randomized control trial2023
  4. 4Effectiveness of a community health worker-delivered care intervention for hypertension control in Uganda: study protocol for a stepped wedge, cluster randomized control trial2022 · 17 citations
  5. 5Preliminary efficacy of a community health worker homebased intervention for the control and management of hypertension in Kiambu County, Kenya- a randomized control trial2024 · 16 citations