title: A randomized controlled trial to evaluate an educational strategy involving community health volunteers in improving self-care in patients with chronic heart failure: Rationale, design and methodology.
abstract: BACKGROUND
  Chronic heart failure (CHF) is an increasingly important health problem worldwide. Effective self-care can improve the outcomes and quality of life in patients with CHF. Acknowledging the important role of educational interventions for improving self-care, we sought to assess a new educational strategy involving community health volunteers (CHVs) that could reduce the cost and, hypothetically, increase the effectiveness of self-care education in patients with CHF.
  
  
  METHODS
  In this ongoing three-arm controlled trial, approved by two human research ethics committees in Australia and Iran, 231 patients with CHF registered at a referral cardiovascular hospital in Iran were randomly allocated into three groups -trained by community health volunteers at patients' homes, rained by formal health professionals at hospital; and a control group with no formal educational exposure. Data obtained through interviewing participants and using the Persian self-care of CHF index (pSCHFI) before and two months after interventions will be analysed using SAS and SPSS.
  
  
  CONCLUSIONS
  The results of this study may help health service systems, especially in countries with limited resources, make use of community volunteers to teach patients with CHF to develop self-care behaviors and skills, reducing the cost of care and improving CHF outcomes. Also, this home-based educational strategy using face-to-face training, if successful, may provide psychosocial supports for patients suffering from chronic illnesses.
  
  
  BACKGROUND
  ACTRN12614000788673 (Australian New Zealand Clinical Trials Registry).
authors.affiliation: Menzies Centre for Health Policy, School of Public Health, Medical School, The University of Sydney, Sydney, NSW Australia ; School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran.
authors.forename: Soraya
authors.initials: S
authors.lastname: Siabani
authors.affiliation: Epidemiology and Occupational Medicine, School of Public Health, Sydney Medical School, The University of Sydney, Sydney, NSW Australia.
authors.forename: Tim
authors.initials: T
authors.lastname: Driscoll
authors.affiliation: Department of Acute and Chronic Care, The Johns Hopkins University, Baltimore, MD USA.
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Davidson
authors.affiliation: Menzies Centre for Health Policy, School of Public Health, Medical School, The University of Sydney, Sydney, NSW Australia.
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Leeder
keywords: Adherence to treatment; Chronic illnesses; Community health workers; Congestive heart failure; Health education; Home-based education; Medical adherence; Self-management