title: Efficacy of a home-based educational strategy involving community health volunteers in improving self-care in patients with chronic heart failure in western Iran: A randomized controlled trial.
abstract: This study aimed to evaluate the effectiveness of a home-based educational strategy using community health volunteers (CHVs) in improving self-care of patients with chronic heart failure (CHF) in comparison with an educational strategy using formal health professionals (FHPs) at hospital, and also with a control group receiving usual care in western Iran.
  
  
  
  A three-arm controlled trial randomly allocated 231 patients with CHF into a control group and two intervention groups undertaking two different educational approaches - a face-to-face education program by CHVs at the patients' homes and a formal education program using paid FHPs at hospital. Data obtained through interviewing patients before and two months after interventions were analyzed. Self-care components significantly increased after the intervention in both interventional groups compared to the control group (p<0.001). Differences between the two strategies were not significant, except for self-care confidence being greater in the groups exposed to the health professionals (p=0.004). The mean and standard deviation (SD) of the changes in self-maintenance, self-management and self- confidence score (each with a maximum score of 100) for the CHVs group were 26.2±12.7, 29.4±11 9.5±17; for the health professional group were 29.5±12, 31.3±12, 18.1±17; and for the control group were 2.7±9, 10.2±10, -0.30±11 respectively.
  
  
  
  The home-based face-to-face education by CHVs improved self-care maintenance and self-care management in patients with CHF as effectively as the education provided by health professionals in a formal health education program, and much better than the usual care.
authors.affiliation: Menzies Center for Health Policy, University of Sydney, Australia School of Public Health, Kermanshah University of Medical Sciences, Iran ssia5034@uni.sydney.edu.au.
authors.forename: Soraya
authors.initials: S
authors.lastname: Siabani
authors.affiliation: Health School, The University of Sydney, Australia.
authors.forename: Tim
authors.initials: T
authors.lastname: Driscoll
authors.affiliation: Department of Acute and Chronic Care, Johns Hopkins University, USA.
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Davidson
authors.affiliation: Menzies Center for Health Policy, University of Sydney, Australia.
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Leeder
mesh_terms: D003150:Community Health Workers; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D007492:Iran; D011634:Public Health; D012648:Self Care; D014838:Volunteers
keywords: Health education; congestive heart failure; home visit; public health; self-management