Evaluation of Community Healh workers creening for CVD

An evaluation of Community Health Workers   screening for CVD in the community in four NHLBI/United Health Centers of   Excellence

Principal Investigators

  • Naomi Levitt,
  • Carlos Mendoza Montano
  • Louise Niessen
  • Maria Teresa Cerqueira
  • Thomas Gaziano

Funding agency

  • National Heart, Lung and Blood Institute   (NHLBI)

Researchers in training

  • Alvaro Rivera, Guatemala

Participating countries

  • Guatemala
  • South Africa
  • Bangladesh
  • US  México border

Participating institutions

  • Chronic Diseases Initiative in Africa (CDIA, University of Cape Town), Cape Town, South Africa
  • INCAP Comprehensive Center for the Prevention of Chronic Diseases   (CIIPEC), Guatemala
  • International Center for Diarrhoeal Disease Research, Bangladesh
  • The U.S. Mexico Border, Pan American Health Organization Office


1. The primary objective of the   study is to determine how well  Community Health Workers (CHWs),  correctly identify persons who are at high   risk for Cardiovascular Diseases (CVD), using a risk prediction tool, by comparing the CHW-generated to a risk score  by a trained  health proffesional.

2. The secondary objective is to   assess if patients, once identified as high risk, are adequately referred and   treated at primary health care centres score generated by a trained health   professional.


This study proposes to train CHWs to use a non-lab   based risk assessment tool to identify persons at high risk for CVD in   community settings in South Africa, Bangladesh, Guatemala, and Mexico. The risk   tool developed in the US population and tested with good performance in   several South African cohorts, uses age, gender, BMI, blood pressure, smoking   status, and history of diabetes mellitus (DM) to calculate an absolute risk   score for developing CVD. The CHW-generated risk scores will then be   compared for agreement to risk scores generated by a trained health   professional. If there is significant overlap in the percent agreement   between the two sets of scores, it will demonstrate that low-level health workers   such as CHWs can be adequately trained to screen for, and identify, those at   high risk for CVD. The referral pattern for high-risk patients from CHWs to a   trained health professional at a community health clinic will also be   assessed. Finally, CHW knowledge levels and retention of knowledge about CVD   and its risk factors will be evaluated.


The project is in its early stages of development.   The field work of the study started in the first semester of   2012.



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