The Attitudes of Rural Community Health Workers Towards Older Adults in Kermanshah, Iran

Background: Community health workers (CHWs) continue to play a crucial role in supporting health service delivery globally. Several CHW programmes around the world face vast challenges which affect their performance.Objectives: This study assessed the performance of CHWs and associated factors in a rural community in Wakiso district, Uganda.Methods: This was a cross-sectional study that employed a structured questionnaire to collect quantitative data from 201 CHWs in Wakiso district. The main study variable was CHW performance based on various roles carried out by CHWs. Multivariable logistic regression in STATA was used to establish the predictors of CHW performance.Results: Only 40 (19.9%) of the CHWs had a high performance which was associated with having attended additional / refresher trainings [AOR=12.79 (95% CI: 1.02-159.26)], and having attained secondary level education and above [AOR=3.93 (95% CI: 1.17-13.24)]. CHWs who were married [AOR=0.29 (95% CI: 0.09-0.94)] were less likely to perform highly. Among CHWs who had received essential medicines for treatment of childhood illnesses, the majority 90.3% (112/124) had experienced stock-outs in the 6 months preceding the study. Despite the majority of CHWs, 198 (98.5%), stating that being motivated was very important in their work, only 91 (45%) said that they were motivated.Conclusion: Additional / refresher trainings are necessary to enhance performance of CHWs. In addition, level of education should be considered while selecting CHWs. The health system challenges of low motivation of CHWs as well as stock-out of medicines need to be addressed to support their work.Keywords: Community health workers, performance, motivation, satisfaction, stock-outs, village health teams, Uganda.

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OPTIMAL HEALTH PROFESSIONAL STAFFING OF PRIMARY CARE AND GERIATRIC PRACTICES SERVING FRAIL OLDER ADULTS

Innovation in Aging ◽

10.1093/geroni/igz038.254 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S66-S66

Author(s):

Karen Donelan ◽

Joanne Spetz

Keyword(s):

Older Adults ◽

Primary Care ◽

Community Health ◽

Community Health Workers ◽

Large Scale ◽

Assessment Tool ◽

Health Workers ◽

Site Assessment ◽

Frail Older Adults ◽

Frail Elders

Abstract This symposium will include 3 papers that provide critical interprofessional and interdisciplinary perspectives on our work to understand and measure staffing in health care teams caring for older adults, and frail older adults. The Health Teams for Frail Elders project was funded by the Gordon and Betty Moore Foundation from August 2016 to October 2018. Dr. Karen Donelan, project Principal Investigator, will chair the session, providing a brief project overview of project aims and activities. A survey and health services researcher, Dr. Donelan will set the context for this large scale project. Dr. Barbara Roberge, a geriatric nurse practitioner who established one of the first senior health programs in the nation along with Dr. Kenneth Minaker at Mass General Hospital, was our primary care and nursing lead on our site visits. She will talk about the care settings we visited, her development of a site assessment tool that covered a range of frail elder needs, and will summarize professional roles and staffing observed within different site types. Dr. Julie Berrett-Abebe, a junior investigator on our team (PhD 2017), will present a paper on the competencies and roles of social workers and community health workers in primary and geriatric practices, as well as the roles of community health workers. Dr. David Auerbach, a national expert in health policy and workforce analysis, will present 4 models of staffing of practices, demonstrating efficiencies in optimizing services for frail elders while minimizing costs.Dr. Joanne Spetz will be the discussant of cross-cutting themes.

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Brief interventions for older adults (BIO) delivered by non-specialist community health workers to reduce at-risk drinking in primary care: a study protocol for a randomised controlled trial

BMJ Open ◽

10.1136/bmjopen-2020-043918 ◽

2021 ◽

Vol 11 (5) ◽

pp. e043918

Author(s):

Tassiane Cristine Santos Paula ◽

Camila Chagas ◽

Ana Regina Noto ◽

Maria Lucia Oliveira Souza Formigoni ◽

Tiago Veiga Pereira ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Primary Care ◽

At Risk ◽

Alcohol Consumption ◽

Usual Care ◽

Community Health ◽

Community Health Workers ◽

Health Workers ◽

Brief Interventions

IntroductionEvidence suggests that brief interventions are effective in reducing alcohol consumption among older adults. However, the effectiveness of these interventions when delivered by community health workers (non-specialists) in a primary healthcare setting is unknown. To our knowledge, this will be the first randomised trial to examine this.Methods and analysisTwo hundred and forty-two individuals considered at-risk drinkers (Alcohol Use Disorders Identification Test-Consumption, AUDIT-C score ≥4) will be recruited and randomly allocated to usual care (waiting-list) or usual care plus an intervention delivered by trained community health workers (non-specialists). Seven primary care units (PCUs) in Sao José dos Campos, Brazil. PCUs are part of the Brazilian public healthcare system (Sistema Único de Saúde).Follow-up6 months.OutcomesThe primary outcome will be the proportion of participants considered at-risk drinkers (AUDIT-C score ≥4). Secondary outcomes will include alcohol consumption in a typical week in the last 30 days (in units per week) assessed by the AUDIT, service use questionnaire, cognitive performance—assessed by The Health and Retirement Study Harmonised Cognitive Assessment, physical activity—assessed by the International Physical Activity Questionnaire, depression—assessed by the Geriatric Depression Scale and quality of life—assessed by the Control, Autonomy, Self-realisation and Pleasure-16 instrument. The analysis will be based on intention-to-treat principle.Ethics and disseminationThis study has been approved by the Ethics Committee of the Universidade Federal de São Paulo, CEP/UNIFESP Project n: 0690/2018; CAAE: 91648618.0.0000.5505. All eligible participants will provide informed consent prior to randomisation. The results of this study will be published in relevant peer-reviewed journals and in conference presentations.Trial registration numberRBR-8rcxkk.

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Improving Community Health Workers’ Attitudes toward Collaborative Practice in the Care of Older Adults: An In-Service Training Intervention Trial in the Philippines

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18199986 ◽

2021 ◽

Vol 18 (19) ◽

pp. 9986

Author(s):

Kathryn Lizbeth L. Siongco ◽

Keiko Nakamura ◽

Kaoruko Seino ◽

TJ Robinson T. Moncatar ◽

Lourdes Marie S. Tejero ◽

...

Keyword(s):

Older Adults ◽

Community Health ◽

Community Health Workers ◽

Health Workers ◽

Linear Regression Analysis ◽

The Philippines ◽

Collaborative Practice ◽

Control Group ◽

Multivariate Linear Regression Analysis ◽

Significant Difference

The objective of this study was to evaluate the efficacy of an in-service, short-term training program in improving the attitudes toward, and readiness and activities for collaboration among community health workers (CHWs) in a primary care setting in the Philippines. A randomized controlled trial was adopted dividing participants into an intervention (n = 42) and a control group (n = 39). Attitudes toward, and readiness and activities for collaboration were measured using three standardized scales before and at 6 months after the training. A significant difference (p < 0.001) was observed in the Attitudes Toward Health Care Teams Scale (ATHCTS) scores between pre- and post-test in the intervention (6.3 ± 8.3 [Mean ± SD]) and control groups (0.7 ± 8.2). Multivariate linear regression analysis showed an independent positive association between the intervention and greater improvement in the ATHCTS score (Coefficient β = 6.17; 95% CI = 0.82, 11.53; p = 0.03) at follow-up, after adjustment for age, years in current occupation, and social support role of participants. The results demonstrated the efficacy of the intervention for improving the attitudes of CHWs toward collaborative practice in the care of older adults.

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