Evidence map›Paper›PMID 31523014›Full record

Trial reportGlobal heart2019

Effect of a Community Health Worker-Based Approach to Integrated Cardiovascular Risk Factor Control in India: A Cluster Randomized Controlled Trial.

Aditya Khetan, Melissa Zullo, Anitha Rani, Rishab Gupta, Raghunandan Purushothaman, Navkaranbir S Bajaj, Sushil Agarwal, Sri Krishna Madan Mohan, Richard Josephson

Registry-linked trialOpen access · hybridAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Global heart, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02115711 (A Community Based Approach to Promote Cardiovascular Risk Factor Control in India, Project SEHAT), which is not on this map. Cited by 31 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
31citing papers in PubMed, 8 pooled it
4.8field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

NCT02115711 nacompletednot on this map

A Community Based Approach to Promote Cardiovascular Risk Factor Control in India, Project SEHAT: A Cluster Randomized Controlled Trial

TypeinterventionalSponsorUniversity Hospitals Cleveland Medical CenterRan2014 to 2017Enrolled1,242ConditionsHypertension, Diabetes, Smoking, Cardiovascular DiseasesArmsCommunity health worker
3 · Its place in the literature

Who cites it

31 citing papers in PubMed, 8 syntheses or guidelines pooled it, 59 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 6 institutions in 2 countries.

Aditya KhetanHarrington Heart & Vascular Institute, University Hospitals, Case Western Reserve University, Cleveland, OH, USA; SEHAT, Dalkhola, India. Electronic address: dradityakhetan@gmail.com.
Melissa ZulloHarrington Heart & Vascular Institute, University Hospitals, Case Western Reserve University, Cleveland, OH, USA; School of Public Health, Kent State University, Kent, OH, USA.
Anitha RaniDepartment of Community Medicine, Sri Ramachandra Medical College and Research Institute, Porur, India.
Rishab GuptaSEHAT, Dalkhola, India.
Raghunandan PurushothamanSEHAT, Dalkhola, India.
Navkaranbir S BajajDivision of Cardiovascular Disease, Department of Internal Medicine and Radiology, University of Alabama, Birmingham, AL, USA.
Sushil AgarwalSEHAT, Dalkhola, India.
Sri Krishna Madan MohanHarrington Heart & Vascular Institute, University Hospitals, Case Western Reserve University, Cleveland, OH, USA.
Richard JosephsonHarrington Heart & Vascular Institute, University Hospitals, Case Western Reserve University, Cleveland, OH, USA; School of Public Health, Kent State University, Kent, OH, USA.
Society for Education Welfare and Action Rural · INCase Western Reserve University · USKent State University · USSri Ramachandra Institute of Higher Education and Research · INUniversity Hospitals of Cleveland · USUniversity of Alabama at Birmingham · US

Funding

National Dissemination of I-Corps@NCATS: Accelerating Translation through CommercializationUL1TR003096 · NCATS · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI GUTIERREZ, ORLANDO M, KIMBERLY, ROBERT P. · 2019 to 2023
$43.6M
UAB Center for Clinical and Translational Science (CCTS)UL1TR001417 · NCATS · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI KIMBERLY, ROBERT P. · 2015 to 2018
$31.4M
NCATS NIH HHS UL1 TR001417NCATS NIH HHS UL1 TR003096
6 · The paper itself

Abstract

backgroundEighty percent of premature mortality from cardiovascular disease occurs in low- and middle-income countries. Hypertension, diabetes, and smoking are the top risk factors causing this disease burden.

objectivesThe study aimed to test the hypothesis that utilizing community health workers (CHWs) to manage hypertension, diabetes and smoking in an integrated manner would lead to improved control of these conditions.

methodsThis was a 2-year cluster (n = 12) randomized controlled trial of 3,556 adults (35 to 70 years of age) in a single town in India, who were screened at home for hypertension, diabetes, and smoking. Of these adults, 1,242 (35%) had at least 1 risk factor (hypertension = 650, diabetes = 317, smoking = 500) and were enrolled in the study. The intervention group had behavioral change communication through regular home visits from community health workers. The control group received usual care in the community. The primary outcomes were changes in systolic blood pressure, fasting blood glucose, and average number of cigarettes/bidis smoked daily among individuals with respective risk factors.

resultsThe mean ± SD change in systolic blood pressure at 2 years was -12.2 ± 19.5 mm Hg in the intervention group as compared with -6.4 ± 26.1 mm Hg in the control group, resulting in an adjusted difference of -8.9 mm Hg (95% confidence interval [CI]: -3.5 to -14.4 mm Hg; p = 0.001). The change in fasting blood glucose was -43.0 ± 83.5 mg/dl in the intervention group and -16.3 ± 77.2 mg/dl in the control group, leading to an adjusted difference of -21.3 mg/dl (95% CI: 18.4 to -61 mg/dl; p = 0.29). The change in mean number of cigarettes/bidis smoked was nonsignificant at +0.2 cigarettes/bidis (95% CI: 5.6 to -5.2 cigarettes/bidis; p = 0.93).

conclusionsA population-based strategy of integrated risk factor management through community health workers led to improved systolic blood pressure in hypertension, an inconclusive effect on fasting blood glucose in diabetes, and no demonstrable effect on smoking. (Study of a Community-Based Approach to Control Cardiovascular Risk Factors in India [SEHAT]; NCT02115711).

Indexed as

AdultAgedBlood PressureCardiovascular DiseasesCluster AnalysisCommunity Health ServicesCommunity Health WorkersDiabetic AngiopathiesFacilities and Services UtilizationFemaleHealth PromotionHumansHypertensionIndiaMaleMiddle Aged

Identifiers

PMID31523014
PMCPMC7358973
OpenAlexW2972780199

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.