The present evidence for the effectiveness of CHW programmes for older adults from ethnic minorities is not univocal. In two studies, we found no significant differences . In five studies, we found some positive effects. We did not find negative effects in any of the studies. Therefore, we conclude with some caution that there are indications that CHWs can help to improve health care use, health behaviour, and health outcomes among ethnic minority older adults. The strength of the evidence differed by outcomecategory. Substantial effects on access to care (mean ER = 0.58) and on health behaviour (mean ER = 0.45) were found. The mean ER for health outcomes was considerably lower (mean ER = 0.17). This might be because an improvement in health status occurs as a consequence of an improvement in health behaviour and access to care
initiated by CHWs. Therefore, effects on health outcomes in contrast to access to care and health behaviour are expected to emerge in the long term. The quality of the included studies was considered to be sufficient, but not optimal. The strength of the effects found for access, health behaviour, and health outcomes did not seem to be associated with study quality. CHWs may be less effective in improving health behaviour and access to care in older adults compared to
younger adults belonging to ethnic minorities. A previous review that focussed on ethnic minority adult women of all ages showed a higher percentage of studies that reported at least one positive result for access to care (100% vs. 66.7% compared to our review) and health behaviour (83.3% vs. 75%). This comparison should, however, be viewed with some caution given the differences in health focus and the type of studies for some of the included studies. Nevertheless, we consider the results of CHWs for older adults to be promising.