Key result
Community health worker-led interventions reduce systolic blood pressure by ~6 mm Hg vs. standard care.
Why the study?
Do community health worker-led multicomponent interventions reduce blood pressure, glycaemic indices, lipid levels, and body mass index compared to standard care in adults with cardio-metabolic diseases in India?
Meta-Analysis (n=7,114)
Lack of blinding due to inherent nature of the interventions
Included 6 cluster RCTs, 4 parallel group RCTs, and 3 pre-post studies
Yes
Do community health worker-led multicomponent interventions reduce blood pressure, glycaemic indices, lipid levels, and body mass index compared to standard care in adults with cardio-metabolic diseases in India?
Answers are grounded in this paper and cite their sources.
Community health worker-led interventions in India significantly lower systolic blood pressure and body mass index in adults with cardiometabolic conditions, supporting task-shifting models for hypertension and obesity control in low-resource community settings.
Background and objectives Cardio-metabolic diseases are leading cause of disability-adjusted life years (DALYs) in India. Community health workers’ (CHW) local proximity and contextual understanding enable low-cost, and sustainable health interventions. This systematic review and meta-analysis of interventional studies aimed to identify types of CHW-led interventions and their effect on cardio-metabolic diseases. Methods Studies done in India (2000-2024) were searched from PubMed, Embase and Scopus databases. Screening of studies, followed by risk of bias assessment, data extraction was done and pooled mean difference (MD), 95% confidence interval (CI) was estimated by the random effect model. Subgroup, sensitivity analysis, and meta-regression was performed along with certainty assessment using grading of recommendations assessment, development and evaluation (GRADE). Results Thirteen studies (10 randomised trial and 3 pre-post studies) involving adults (mean age ranging from 45 to 65 yr) with hypertension, diabetes, stroke, and overweight were included in systematic review and 9 studies were included in meta-analysis. The CHW-led intervention significantly reduced systolic blood pressure (n=7,114; MD −5.5 mm Hg, 95% CI −9.0 to −1.9; P= 0.041; I 2 =79.3%), with higher effect among people with hypertension (MD −7.5 mm Hg) and body mass index (MD −0.63 kg/m 2 ; P= 0.038) in intervention group. No significant change was observed in diastolic blood pressure, fasting blood glucose, glycated haemoglobin, and lipid profiles. Sensitivity analysis revealed no differential effect, and meta-regression showed no significant covariates. GRADE certainty of evidence was low to very low for outcome variables. Interpretation and conclusions CHW-led interventions in an Indian community setting showed beneficial effect on cardiometabolic outcomes, particularly blood pressure and body mass index, though the strength of evidence ranged from weak to moderate.
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Mandal et al. (2026) conducted a meta-analysis in Cardio-metabolic diseases (hypertension, diabetes mellitus, stroke, overweight/obesity, dyslipidaemia) (n=7,114). Community health worker (CHW)-led multicomponent interventions (lifestyle modification, health education, monitoring, peer support) vs. Standard care or no intervention was evaluated on Systolic blood pressure (SBP) (MD -5.5 mm Hg, 95% CI -9.0 to -1.9, p=0.041). Community health worker-led interventions significantly reduced systolic blood pressure by a pooled mean difference of -5.5 mm Hg (95% CI -9.0 to -1.9, P=0.041) compared to standard care in India.
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