Table 1 Study Characteristics

Lopez 2017

(n = 370)

Non-randomized controlled quasi-experiment

To assess feasibility and effectiveness of CHW and health advocate initiative in public housing residents with high chronic disease burden

Low income, adults with either asthma (37.7%), hypertension, or diabetes recruited from 5 East Harlem public housing developments

6 or more CHW visits as well as referrals to health advocates as needed; CHW and community based health advocate

BP, BMI, self reported physical activity, mental health status, self-efficacy, QOL, healthcare access, disease management

3 months

Health advocate support alone

Improvement in self-reported physical activity (p = 0.005), change in insurance (11% vs 4%; p = 0.009), and change in primary doctor (14% vs 6%; p = 0.024); no between group difference in asthma self efficacy or general mental health

Krieger 2014

(n = 366)

Randomized controlled trial

To assess whether CHW in home self-management support reduces asthma morbidity

Low-income adults with poorly controlled asthma primarily recruited from public health, community, and hospital-based clinics

5 CHW home visits and as needed support via telephone, e-mail, or additional home visits, environmental trigger assessment and intervention; CHW

Asthma symptom free days, asthma related QOL, asthma-related unscheduled health care use; night symptoms, asthma exacerbations, medication use, pulmonary function, medication use, absenteeism, general health status

12 months

Usual care plus community resource information and educational pamphlets

Increase in mean symptom free days per 2 weeks (2.02 d)(p < 0.001) and increase in asthma-related QOL (mean 0.50 points)(p < 0.001), fewer asthma attacks & night symptoms, improved asthma control and health status in intervention group; both had decreased urgent care use (1.3–1.5 fewer episodes)^a; no change in PFT or absenteeism between groups

Martin 2006

(n = 47)

Cross sectional and longitudinal analysis

To assess whether CHW home visits enabled changes in home asthma triggers

Inner-city, low-income, Latino adults with asthma recruited from community center

Initial visit for intervention followed by 3 home visits for data collection; CHW

ED and urgent care utilization, hospitalizations, asthma severity, albuterol use, home asthma triggers

3, 6, and 12 months

NA

Decrease in home trigger score by 0.41(p < 0.01) with each home visit; no change in ED visit, urgent care visit, hospitalization at 3,6,12 m follow up; no change in daily albuterol use or asthma severity; improvement in individual home asthma triggers (chlorine, aerosols, use of air filter) at 12 m follow up

Martin 2009

(n = 42)

Randomized pilot controlled trial

To assess whether CHW intervention improves asthma self-efficacy, clinical outcomes, and self-management behaviors

Low-income African American adults with asthma recruited from clinic

4 group sessions led by a social worker at primary care clinics and 6 CHW in-home visits; CHW and social workers

Asthma self efficacy, asthma QOL, coping skills, self management behavior, use of steroids, symptoms

3 and 6 months

Asthma education materials alone

Higher asthma self-efficacy at 3 months, improved asthma-related QOL and coping at 6 months; no change in use of inhaled steroids, number of symptomatic nights and days, use of a spacer, and asthma knowledge at 3 and 6 months