How community health workers improve preventive care outcomes: an integrative review
Byoungduck HAN, Yang Hyun KIM, Jaedong LEE and Seon Mee KIM
Community Health Workers (CHWs) are key contributors to strengthening primary care and expanding access to preventative medicine. In Brazil, CHWs are central to the Family Health Strategy, delivering health education to communities, partaking in vaccination campaigns, and facilitating longitudinal patient follow-up. To understand the impact of CHWs on primary care worldwide, a synthesis of Brazilian and international findings is needed. Keywords: Community Health Workers; Preventive Medicine; Vaccination; Cancer Screening; Primary Health CareThe primary objective of this work was to evaluate how CHWs influence: Vaccination coverage, cancer screening uptake and avoidable hospital admissions for chronic diseases. The secondary objective was to identify mechanisms through which community-based work increases engagement with primary care services.An integrative review was conducted across PubMed, Scopus, and LILACS. Search terms included descriptors related to “Community Health Workers”, “Vaccination”, “Cancer Screening”, and “Preventive Medicine”. Filters applied: full-text availability, publications from the last 10 years, English or Portuguese. A total of 606 records were retrieved. After duplicate removal and abstract/full-text screening, 29 studies were included.Of the 29 studies included, 17 reported increased vaccination rates associated with CHWs interventions. These workers acted as trusted sources of information—reducing vaccine hesitancy—and, in several contexts, served as vaccinators, reaching remote and vulnerable populations. 8 studies demonstrated improvements in cancer screening uptake linked to CHWs outreach and navigation. 5 studies highlighted reductions in avoidable hospitalisations and improvements in chronic disease management, reinforcing the role of CHWs in preventive care and early clinical intervention.CHWs improve preventive care by bringing people closer to the health system. In Brazil, many CHWs live in the same communities they serve, strengthening trust and helping them understand local needs. This proximity helps reach isolated or vulnerable groups and shows how community-based work can strengthen public health.CHWs significantly improve preventive care outcomes by increasing vaccination and screening uptake, and reducing avoidable complications. Across international and Brazilian contexts, trust-building, relational continuity and local community ties emerges as key factors behind these improvements.
