scholarly journals Patients’ Perspectives on the Feasibility, Acceptability, and Impact of a Community Health Worker Program: A Qualitative Study

2020 ◽  
Author(s):  
Wei Chang ◽  
May Oo ◽  
Adriana Rojas ◽  
April Joy Damian

Abstract Background: Growing evidence suggests that community health workers (CHWs) can play a key role in delivering culturally competent preventive care services, addressing social determinants of health (SDOH), and improving the health outcomes of underserved populations. This study sought to understand the experiences of patients with Type 2 diabetes working with a CHW in a safety net setting.Methods: A convenience sample (n=13) who participated in a six-month CHW pilot program at a federally qualified health center (FQHC) was recruited for in-person or telephone semi-structured interviews that included 17 open-ended questions regarding patients’ experiences with the CHW program. Interview transcripts were analyzed using a traditional text analysis method based on a grounded theory approach to identify themes related to the participants’ perspectives of the CHW program.Results: This study highlights the CHW program can improve satisfaction in accessing health services and community resources, and overall health outcomes of patients in the safety net practices. Moreover, patients discussed the positive impact of the CHW program in terms of improved medical knowledge, access to medical services, and self-efficacy. The CHW’s professionalism also helped to establish rapport and trust that further supported behavior changes related to patients’ health goals.Conclusion: Patients’ overall positive perception regarding the feasibility, acceptability, and impact of the CHW program indicated that the intervention may be a viable solution to address the health and social needs of patients in safety net settings. Additionally, CHW programs can help to bridge the gap between patients and healthcare team by mitigating barriers to care.

2021 ◽  
Vol 9 ◽  
Author(s):  
Jenerius A. Aminawung ◽  
Tyler D. Harvey ◽  
Jerry Smart ◽  
Joseph Calderon ◽  
Anna Steiner ◽  
...  

Over half a million individuals return from United States prisons and millions more from jails every year, many of whom with complex health and social needs. Community health workers (CHWs) perform diverse roles to improve health outcomes in disadvantaged communities, but no studies have assessed their role as integrated members of a primary care team serving individuals returning from incarceration. Using data from participants who received primary care through the Transitions Clinic Network, a model of care that integrates CHWs with a lived experienced of incarceration into primary care teams, we characterized how CHWs address participant health and social needs during interactions outside of clinic visits for 6 months after participants established primary care. Among the 751 participants, 79% had one or more CHW interactions outside of the clinic documented. Participants with more comorbid conditions, longer stays during their most recent incarceration, and released with a prescription had more interactions with CHWs compared to those with fewer comorbidities, shorter stays, and no prescription at release. Median number of interactions was 4 (interquartile range, IQR 2–8) and 56% were in person. The most common issues addressed (34%) were social determinants of health, with the most common being housing (35%). CHWs working in interdisciplinary primary care teams caring for people with histories of incarceration perform a variety of functions for clients outside of scheduled primary care visits. To improve health outcomes among disadvantaged populations, CHWs should be able to work across multiple systems, with supervision and support for CHW activities both in the primary care clinic and within the community.


2019 ◽  
Vol 10 ◽  
pp. 215013271989920 ◽  
Author(s):  
Kevin Fiori ◽  
Milani Patel ◽  
Dana Sanderson ◽  
Amanda Parsons ◽  
Sybil Hodgson ◽  
...  

Purpose: Social and economic factors have been shown to affect health outcomes. In particular, social determinants of health (SDH) are linked to poor health outcomes in children. Research and some professional academies support routine social needs screening during primary care visits. Translating this recommendation into practice remains challenging due to the resources required and dearth of evidence-based research to guide health center level implementation. We describe our experience implementing a novel social needs screening program at an academic pediatric clinic. Methods: The Community Linkage to Care (CLC) pilot program integrates social needs screening and referral support using community health workers (CHWs) as part of routine primary care visits. Our multidisciplinary team performed process mapping, developed workflows, and led ongoing performance improvement activities. We established key elements of the CLC program through an iterative process We conducted social needs screens at 65% of eligible well-child visits from May 2017 to April 2018; 19.7% of screens had one or more positive responses. Childcare (48.8%), housing quality and/or availability (39.9%), and food insecurity (22.8%) were the most frequently reported needs. On average, 76% of providers had their patients screened on more than half of eligible well-child visits. Discussion: Our experience suggests that screening for social needs at well-child visits is feasible as part of routine primary care. We attribute progress to leveraging resources, obtaining provider buy-in, and defining program components to sustain activities.


2021 ◽  
pp. 104973232110035
Author(s):  
Felicia Casanova ◽  
Felicia M. Knaul ◽  
Natalia M. Rodriguez

South Florida agricultural regions, home to Latinx immigrant farmworkers, report higher rates of late-stage breast cancer diagnosis than national, state, and county-level averages. We conducted a community-based qualitative study on the needs, health knowledge gaps, barriers to breast cancer screening, and the role of community health workers (CHWs) in supporting the community’s access to early detection services. We conducted three CHW focus groups (FGs) ( n = 25) and in-depth interviews ( n = 15), two FGs ( n = 18) and in-depth interviews ( n = 3) with farmworker community members, and informal interviews with cancer clinicians ( n = 7). Using a grounded theory approach, five core themes regarding the community’s barriers to accessing health care services emerged: (a) lack of information; (b) social and economic barriers; (c) cultural factors; (d) fears and mistrust; and (e) psychosocial concerns. Findings yield implications for community health practice, the potential impact of CHWs, and the production of breast cancer education to improve health equity along with the care continuum.


2019 ◽  
Vol 3 (s1) ◽  
pp. 80-81
Author(s):  
Alejandra Hurtado de Mendoza ◽  
Kristi Graves ◽  
Sara Gómez-Trillos ◽  
Minna Song ◽  
Lyndsay Anderson ◽  
...  

OBJECTIVES/SPECIFIC AIMS: The goal of the study was to assess the acceptability of a culturally targeted narrative video and identify potential avenues for dissemination in a sample of bilingual community health workers who provide services to the Latino community in the United States. METHODS/STUDY POPULATION: We piloted the video in a sample of bilingual community health workers who provide services to Latinos (n=31). After watching the video, participants filled out a survey. The survey captured sociodemographic data (e.g. education), their role and experience working with Latinos (e.g. patient navigators), acceptability of the video (e.g. general satisfaction, length of the video, amount of information), and potential dissemination (e.g., dissemination channels, preferred settings to watch the video, and preferred context). Three open ended questions captured information about how the video could be useful for the Latino community, what they liked the most from the video, and suggestions for improvement. Data was entered in SPSS version 25. We used descriptive statistics to analyze the survey, and content analysis to summarize the feedback from the open-ended questions. RESULTS/ANTICIPATED RESULTS: Participants (n = 31) had an average age of 46 years (SD=16.99), all self-identified as Hispanic or Latinos, most were female (90.3%), and worked as patient navigators (29%) or community outreach workers (25.8%). The video’s general acceptability was very high. Participants reported high ratings for overall satisfaction, how much they liked the video, enjoyed it, and considered it to be interesting (all means >9.6, range 1-10). Most participants strongly agreed or agreed that the length was adequate (80.7%), that the information presented was very helpful (100%), that the video could be useful for the Latina community (96.8%), and that they would share the video with women at-risk of HBOC (100%). The highest endorsed channels for dissemination were Facebook (90.3) and YouTube (87.1%). The highest endorsed settings were community centers (100%), churches (96.8%), and hospitals (80.6%). Most participants (90.3%) considered that the best context to watch the video would be with relatives, followed by watching with other women at-risk of HBOC (71.0%), friends (71.0%), and lastly by oneself (41.9%) DISCUSSION/SIGNIFICANCE OF IMPACT: This study represents a multidisciplinary approach to intervention development that aims to reduce well-documented knowledge gaps and disparities in the use of GCRA among at-risk Latinas. A culturally targeted video has the potential to reach underserved populations with low literacy and English proficiency and it can be widely disseminated. The video was well received by community health workers who reported high acceptability. These findings are promising given that community health workers could play a key role in the dissemination of the video if it is proven to be efficacious.


Author(s):  
Tyler Prentiss ◽  
John Zervos ◽  
Mohan Tanniru ◽  
Joseph Tan

Community health workers (CHWs) have a longstanding role in improving the health and well-being of underserved populations in resource-limited settings. CHWs are trusted in the communities they serve and are often able to see through solutions on community challenges that outside persons cannot. Notwithstanding, such solutions often must be low-cost, easily implementable, and permit knowledge gaps among CHWs to be filled via appropriate training. In this sense, use of cost-effective information technology (IT) solutions can be key to increasing access to knowledge for these community agents. This paper highlights insights gleaned from a pilot study performed in Detroit, Michigan with a group of CHWs in basic grant-writing training via an e-platform, the Community Health Innovator Program (CHIP). The results are discussed within the context of learning theory. It is concluded that e-platforms are necessary for CHWs to leverage knowledge from multiple sources in an adaptive environment towards addressing ever-evolving global health challenges.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Gupta ◽  
S Tomar ◽  
A Dey ◽  
D Chandurkar

Abstract Given the high Neo-natal mortality in the state of Uttar Pradesh, India, an emphasis has been given to community health workers (CHW). CHW provides behavior push to pregnant women for utilizing health services, through the strategies of household contact and messaging. However, the disparity in health outcomes and interaction of CHW is profoundly affected by socio-economic determinants; still, the evidence is limited. This study aims to explore socio-economic inequities in quantity and quality of contacts by the CHW and its differential effect on health service utilization. Multistage sampling design identified live births in the last 12 months across the 25 highest-risk districts of Uttar Pradesh(n = 3703). Regression models described the relation between household demographics and CHW contact & specific messaging and interactions of demographics and CHW contact & messaging in predicting health service utilization ( > = 4 antenatal care (ANC) visits, Institutional delivery and 100 iron folic acid (IFA) consumption). No differential likelihood in contact of CHW and specific messaging is found. Further, association of CHW contacts and specific messaging with health outcomes were significantly affected by socio-economic determinants.2 or more contacts along with specific messaging increased the odds of 4+ ANC to a higher degree among illiterate women compared to literate women(AOR:3.39, 95% CI:2.28-5.04 vs AOR:1.44, 95% CI:1.09-1.92). Similarly, the odds of facility delivery increased to a higher degree among lower wealth women compared to higher wealth women (AOR:3.41, 95% CI:2.47-4.71 vs. AOR:1.53, 95% CI: 1.09-2.15). Specific messaging, along with CHW contacts, have a higher magnitude of effects on the marginalized population. This study provides evidence for adjusting implementation strategies based on socio-economic determinants to achieve equitable health service utilization. However, further research on training of CHW on heterogeneous interaction is recommended Key messages There exists differential effects of quantity and quality of contact by community health workers on health service utilization across the different socio-economic strata. Implementation agencies in the LMIC can reduce health inequity by shifting from coverage-oriented target approach towards more prioritized and focused interaction across socio-economic groups.


2019 ◽  
Vol 14 (1) ◽  
pp. 6-18
Author(s):  
Manisha Singh ◽  
Ishwar Tiwari ◽  
Dinesh Bhandari ◽  
Basanta Katwal

Aims: To identify existing interventions in South East Asian countries implemented to prevent postpartum depression (PPD) and explore the possibility of replication of such interventions in Nepal to reduce it. Methods: The paper reviewed the risk factors and preventive strategies implemented in South East Asian countries to prevent PPD. Results: Enough actions have not been taken to address PPD despite of high prevalence in the reviewed countries (Bangladesh, India, Pakistan, Srilanka and Nepal). However, some of the interventions used such as cognitive behavior therapy, education for girls, poverty alleviation program, participatory approach for empowerment and involvement of community health workers have shown positive impact on reducing PPD. Conclusions: The interventions used in South East Asian countries were simple in design intervention and mostly conducted through community health workers; it showed a possibility of replication in Nepal as it already has sufficient community workforces working in maternal and child health.   Keywords: interventions, maternal depression, maternal mental health, post–partum depression, prevention, south asia, strategies


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