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MINI REVIEW article

Front. Stroke

Sec. Preventative Health and Stroke Complications

Volume 4 - 2025 | doi: 10.3389/fstro.2025.1658612

This article is part of the Research TopicPerson and Community Centred Approaches to Transitions of CareView all 6 articles

Community Health Worker Roles in Intervention Delivery: A Scoping Review of Heart Disease and Stroke Prevention Trials in the United States

Provisionally accepted
Imama  Ali NaqviImama Ali Naqvi*Clare  BassileClare BassileS  Reza EbadiS Reza EbadiDakembay  E HoyteDakembay E HoyteLauren  N PaguiriganLauren N PaguiriganJuan  MeyrelesJuan MeyrelesGlenn  McmillanGlenn McmillanIan  KronishIan KronishOlajide  A WilliamsOlajide A Williams
  • Columbia University, New York City, United States

The final, formatted version of the article will be published soon.

Heart disease (HD) and stroke risk can be reduced with adequate cardiovascular disease (CVD) disease prevention as outlined in the American Heart Association's Life's Essential 8 guidelines for modifiable health behaviors. This scoping review examines the roles of Community Health Workers (CHWs) in CVD prevention trials across the United States. In the 24 clinical trials identified, our review emphasizes the effectiveness of CHWs in improving health behaviors and outcomes, particularly for underserved populations with limited access to healthcare. CHWs were actively engaged in implementing interventions, providing culturally sensitive education, offering health coaching, and supporting lifestyle modifications such as increased physical activity and medication compliance. Notably, while most studies focused on HD, only three specifically targeted secondary stroke prevention. Beyond their roles delivering behavioral interventions, CHWs supported research efforts by collecting data and maintaining participant involvement. However, their integration into academic teams was inconsistent in terms of scope of practice and level of interprofessional engagement. Further, CHW research contributions were rarely recognized with a handful acknowledged in publications. Training for CHWs generally included disease-specific knowledge and communication skills. CHW training programs varied considerably in their scope and standards with unclear role definitions and insufficient collaboration with academic institutions. To enhance CHW-led preventive health care, developing standardized training frameworks, defining CHW responsibilities in clinical and research collaborations, and building sustainable community-academic partnerships are suggested. These actions could significantly increase CHWs' role in reducing CVD disparities, thereby promoting more equitable health care across the US.

Keywords: community health worker, Preventive trials, Health Promotion, Stroke prevention, Cardiovascular disease prevention

Received: 03 Jul 2025; Accepted: 01 Sep 2025.

Copyright: © 2025 Naqvi, Bassile, Ebadi, Hoyte, Paguirigan, Meyreles, Mcmillan, Kronish and Williams. 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: Imama Ali Naqvi, Columbia University, New York City, United States

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