ArticleBMC public health2019
Cost-effectiveness of a statewide public health intervention to reduce cardiovascular disease risk.
Article in BMC public health, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
17 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Decision-analytic models in the economic evaluation of community health worker programmes globally: a systematic review.BMJ global health · 2026Pooled it
- Systematic literature review and meta-analysis of cardiovascular risk factor management in selected Asian countries.Journal of comparative effectiveness research · 2023Pooled it
- Impact of Community Health Workers on Access to Care for Rural Populations in the United States: A Systematic Review.Journal of community health · 2022Pooled it
- Cost-Effectiveness of Polygenic Risk Score-Guided Statin Therapy for Cardiovascular Disease Prevention in Singapore.JACC. Asia · 2026Article
- Cost-Effectiveness of the Support and Services at Home (SASH) Program for Cardiovascular Risk Factors: A Community-Based Approach to Healthy Aging in Place.Health services research · 2026Article
- Bridging the implementation gap in cardiovascular prevention: a narrative review and call to action.International journal of public health · 2026Review
- Long-term cost-effectiveness of pharmacist-managed hypertension care in China.BMC health services research · 2025Article
- Bridging communities, prevention, and heart health: U.S. strategies for CHW cardiovascular training and integration.Frontiers in epidemiology · 2025Review
- Drug-Resistant Tuberculosis Hotspots in Oliver Reginald Tambo District Municipality, Eastern Cape, South Africa.Infectious disease reports · 2024Article
- The Financial Impact of an Employee Wellness Program Focused on Cardiovascular Disease Risk Reduction.Healthcare (Basel, Switzerland) · 2024Article
- Community health worker perspectives: examining current responsibilities and strategies for success.Archives of public health = Archives belges de sante publique · 2024Article
- Association of sleep characteristics with cardiovascular disease risk in adults over 40 years of age: a cross-sectional survey.Frontiers in cardiovascular medicine · 2024Article
- Optimizing cardiovascular disease risk screening in a low-resource setting: cost-effectiveness of program modifications in Sri Lanka modelled with nationally representative survey data.BMC public health · 2023Article
- "Community health workers bring value and deserve to be valued too:" Key considerations in improving CHW career advancement opportunities.Frontiers in public health · 2023Article
- Population health interventions for cardiometabolic diseases in primary care: a scoping review and RE-AIM evaluation of current practices.Frontiers in medicine · 2023Article
- Screening for Cardiovascular Disease in Pregnancy: Is There a Need?Journal of cardiovascular development and disease · 2022Review
- Screening for primary aldosteronism in the hypertensive obstructive sleep apnea population is cost-saving.Surgery · 2022Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe cost-effectiveness of community health worker (CHW)-based cardiovascular disease (CVD) risk-reduction interventions is not well established. Colorado Heart Healthy Solutions is a CHW-based intervention designed to reduce modifiable CVD risk factors. This program has previously demonstrated success, but the cost-effectiveness is unknown. CHW-based interventions are potentially attractive complements to healthcare delivery because laypersons implement the intervention at a lower cost relative to medical care and may be attractive in rural settings with limited clinical resources.
methodsCHWs performed screenings and provided ongoing participant support within predominantly rural communities. A point-of-service software tool was used to generate 10-year Framingham CVD risk scores and assist CHWs to make medical referrals and provide ongoing individualized support for lifestyle changes. A sample of program participants returned for reassessment of risk factors. We calculated quality-adjusted life years (QALYs) gained and program costs using a Markov model. Transition probabilities were calculated using Framingham risk equations or derived from the literature using the observed mean reduction in 10-year CVD risk score over of 37- months follow-up. Program cost-effectiveness was calculated for both at-risk (abnormal baseline CVD risk factors) and overall program populations.
resultsThe base-case scenario evaluating a 52-year-old male participant revealed an incremental cost savings of $3576 and a gain of 0.16 QALYs associated with the intervention. Cost savings were greater in at-risk populations. The economic dominance of the model was robust in multiple sensitivity analyses.
conclusionsA community-based CVD intervention demonstrated to reduce CVD risk is cost-effective. This suggests that population-based public health programs may have the potential to complement primary care preventative services to improve health and reduce the burden of traditional medical care.
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