REVIEW article
Front. Epidemiol.
Sec. Cardiovascular Epidemiology
This article is part of the Research TopicInnovative Models for Community Health: Integrative Approaches to Public Health and WellnessView all 15 articles
Bridging Communities, Prevention, and Heart Health: U.S. Strategies for CHW Cardiovascular Training and Integration
Provisionally accepted
Akua Asare
Melvin Echols*- American College of Cardiology, Atlanta, United States
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Background: In the United States, cardiovascular disease (CVD) disproportionately affects communities facing adverse social determinants of health (SDOH). Community Health Workers (CHWs) can bridge gaps in trust, navigation, and culturally tailored education. Methods: We conducted a U.S.–focused narrative review (2015–2025) of PubMed, Scopus, and Google Scholar, prioritizing empirical evaluations of CHW-led CVD interventions, training models, integration strategies, and financing mechanisms. International CHW programs were used only to extract practices transferable to U.S. delivery and payment contexts. Results: Multidisciplinary team-based care demonstrates that engaging CHWs in US regions improves blood pressure control and medication adherence. Economic evaluations increasingly support CHW models for CVD prevention and control. Effective programs specify CHW task bundles (e.g., self-measured BP onboarding, adherence coaching, care navigation, SDOH linkage) and align training with national core competencies. Integration pathways include clinic-embedded, payer-based, public health, and community-based partnerships. U.S. reimbursement options are emerging through Medicare Community Health Integration/Principal Illness Navigation and state Medicaid mechanisms. Faith-based collaborations can extend reach when coupled with standardized training and simple outcome tracking. Conclusions: For U.S. health systems and payers, immediate priorities are (1) competency-based CHW training with cardiac modules, (2) sustainable reimbursement tied to cardiovascular quality metrics, and (3) a minimal outcome set to demonstrate value. Global best practices
Keywords: Community Health Workers, Cardiovascular health, health equity, Medication Adherence, Culturally competent care, Faith-Based Health Initiatives, Insurance Navigation, Chronic disease management
Received: 19 Apr 2025; Accepted: 29 Nov 2025.
Copyright: © 2025 Asare and Echols. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Melvin Echols
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.