Community Health Worker Interventions for Older Adults with Complex Health Needs: A Systematic Review

Meaghan A. Kennedy
Kayla E. Hatchell
Peter R. DiMilia
Stephanie M. Kelly
Heather B. Blunt
Pamela J. Bagley
Michael A. LaMantia
Charles F. Reynolds III
Rebecca S. Crow
Tara N. Maden
S. Logan Kelly
Jacqueline M. Kihwele
John A. Batsis
Peer-Reviewed Article
January 2021


Community health worker-led interventions for older adults with complex needs show evidence of improving participant mood and functional outcomes.


While there are increasing numbers of older adults with complex needs, there are insufficient health care workers with geriatrics training to care for this population. Interventions led by community health workers (CHWs), which have shown strong positive outcomes in the general adult population with complex health and social needs, may help to improve care delivery for older adults. This systematic review examined the evidence base on CHW-led interventions for older adults with multimorbidity, frailty, disability, or high utilization.


The nine CHW-led interventions included in this systematic review ranged in duration from two to 12 months, with three conducted within the United States. While all interventions incorporated a psychosocial or behavioral approach, the specific details of each intervention varied. The overall quality of the evidence was moderate to low, but there was one high-quality randomized controlled trial of a CHW-delivered cognitive-behavioral therapy-based psychosocial intervention (combined with group exercise) that showed significant improvements in mood and function for older adults with mood symptoms and disability. Another pilot randomized controlled trial of a home-based behavioral change intervention with an exercise component also showed improved mood and function as well as participant satisfaction.


CHW-led multicomponent interventions for older adults with early-stage disability and frailty can support their functional capacity through an integrated approach, and have been shown to improve mood and functional outcomes. While there is limited overall evidence on the impact of CHW-led interventions for older adults with complex needs, future research may identify effective interventions that support positive functional and health outcomes and address geriatric workforce shortages.

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