{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T18:19:22Z","timestamp":1787768362332,"version":"build-2784847793"},"reference-count":58,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosglobalpublichealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Glob Public Health"],"abstract":"<jats:sec id=\"sec025\">\n                    <jats:title\/>\n                    <jats:p>\n                      Cardiometabolic diseases (CMDs) disproportionately affect vulnerable populations worldwide. Community health worker (CHW)\u2013led interventions may reduce risk and improve preventive care, but their effectiveness remains unclear. This systematic review and meta-analysis evaluated their effectiveness on cardiometabolic outcomes in vulnerable groups. A comprehensive search of PubMed\/MEDLINE, Scopus, Embase, ClinicalTrials.gov, and Cochrane Library was performed from January 1, 2000 to December 20, 2025, for randomized trials of CHW-led interventions on cardiometabolic outcomes. Primary outcomes were systolic and diastolic blood pressure; secondary outcomes were body mass index (BMI), glycosylated hemoglobin (HbA1c), and low-density lipoprotein cholesterol (LDL-C). Outcomes were pooled as mean differences using the generic inverse variance method; heterogeneity was assessed using I\n                      <jats:sup>2<\/jats:sup>\n                      . Thirty randomized trials (15,295 participants) were included. CHW-led interventions significantly improved systolic blood pressure (WMD\u2009= \u22123.72 mmHg; 95% CI: \u22125.94 to \u22121.51; I\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200999.1%) and diastolic blood pressure (WMD\u2009= \u22122.22 mmHg; 95% CI: \u22123.50 to \u22120.95; I\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200998.6%); 95% prediction intervals crossed the null for all five outcomes (e.g., SBP: \u221215.12 to 7.67 mmHg), indicating uncertainty at a new site. BMI and HbA1c improved modestly but were attenuated to non-significance by trim-and-fill analysis, suggesting publication bias; LDL-cholesterol effects were not significant. SBP reductions were significant in low- and middle-income countries (LMICs) (WMD\u2009= \u22125.09 mmHg; 95% CI: \u22127.57 to \u22122.60) but not high-income countries (HICs), with the largest effects in Africa. GRADE certainty was low for blood pressure, moderate for BMI, very low for HbA1c, and low for LDL-cholesterol. CHW-led interventions modestly improve cardiometabolic outcomes in vulnerable populations, with low-to-very-low certainty evidence for blood pressure and glycemic control and moderate certainty for BMI, supporting a potential role in cardiovascular risk-reduction strategies, particularly in LMICs. However, wide prediction intervals and non-significant meta-regression for intervention design features (contact frequency, duration, delivery format) warrant cautious, hypothesis-generating interpretation pending higher-quality trials.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec001\">\n                    <jats:title>Systematic review Registration<\/jats:title>\n                    <jats:p>\n                      <jats:bold>Registration Number:<\/jats:bold>\n                      PROSPERO 2025\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/ct2\/show\/CRD420251248842\" xlink:type=\"simple\">CRD420251248842<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pgph.0007191","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T17:33:04Z","timestamp":1787765584000},"page":"e0007191","update-policy":"https:\/\/doi.org\/10.1371\/journal.pgph.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effects of community health worker\u2013led interventions on cardiometabolic outcomes in vulnerable populations: A systematic review and meta-analysis"],"prefix":"10.1371","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-2319-3899","authenticated-orcid":true,"given":"Ismaila Ajayi","family":"Yusuf","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-8313-6350","authenticated-orcid":true,"given":"Ihesiulo","family":"Alozie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-6023-1756","authenticated-orcid":true,"given":"Micah Nnabuko","family":"Okwah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vikash","family":"Kumar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1898-9473","authenticated-orcid":true,"given":"Zubeda","family":"Idris-Saeed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6108-9497","authenticated-orcid":true,"given":"Hakeem","family":"Popoola","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Babawale","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6756-0000","authenticated-orcid":true,"given":"Daniel","family":"Adepoju","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3582-1380","authenticated-orcid":true,"given":"Ayotunde","family":"Famokunwa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omolaso","family":"Oluwabamise","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,8,26]]},"reference":[{"issue":"2","key":"pgph.0007191.ref001","first-page":"555834","article-title":"Cardiometabolic diseases: a global perspective","volume":"12","author":"GH Rao","year":"2018","journal-title":"J Cardiol Cardiovasc Ther"},{"key":"pgph.0007191.ref002","unstructured":"World Health Organization. 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