Community health workers involvement in preventative care in primary healthcare: a systematic scoping review

Abstract

ObjectivesTo review effective models of community health worker (CHW) involvement in preventive care for disadvantaged culturally and linguistically diverse (CALD) patients in primary healthcare (PHC) that may be applicable to the Australian context.DesignSystematic scoping review.Data sourcesThe studies were gathered through searching Medline, EMBASE, EMCARE, PsycINFO, CINAHL and online portals of relevant organisations.Eligibility criteriaAll selected studies were original research studies which essentially evaluated preventive intervention undertake by CHWs in PHC. The intervened population were adults with or without diagnosed chronic health disease, culturally and linguistically diverse, or vulnerable due to geographic, economic and/or cultural characteristics that impede or compromise their access to healthcare.Data extraction and synthesisData extraction was undertaken systematically in an excel spreadsheet while the findings were synthesised in a narrative manner. The quality appraisal of the selected studies was performed using effective public health practice project quality assessment tool.ResultsA total of 1066 articles were identified during the initial search of six bibliographic databases. After screening the title, abstract and full text, 37 articles met the selection and methodological criteria and underwent data extraction. A high-quality evidence-base supporting the positive impact of CHWs supporting patients’ access to healthcare and influencing positive behaviour change was found. Positive impacts of CHW interventions included improvements in clinical disease indicators, screening rates and behavioural change. Education-focused interventions were more effective in improving patient behaviour, whereas navigation interventions were most effective in improving access to services. Implementation was enhanced by cultural and linguistic congruence and specific training of CHWs in the intervention but reduced by short duration interventions, dropouts and poor adherence of patients.ConclusionThe evidence generated from this systematic scoping review demonstrates the contribution of CHWs to improving access to preventive care for patients from CALD and disadvantaged backgrounds by providing both education and navigational interventions. More research is needed on CHW training and the incorporation of CHWs into primary health care (PHC) teams.

How can coproduction help to deliver culturally responsive disability support? A case study from Australia

“…This understanding adds to the three components of cultural cognition, attitude and skills. The Chinese participants' attitude differed from many previous studies that emphasise the importance of bilingual staff with the same language and cultural background as people using services (Robertson & Travaglia, 2015;Settlement Services International, 2018Sharma et al, 2019;Torres et al, 2014). While bilingual staff are advantageous, they are insufficient for quality services for two reasons.…”

“…cultural brokers, and cross-cultural training for workforce (Robertson & Travaglia, 2015;Settlement Services International, 2018Sharma et al, 2019;Torres et al, 2014), have their limitations. Clients might not consider surveys to be a trustworthy or culturally appropriate space for free expression about their unmet service needs.…”

“…The Chinese participants reported two qualities that they considered crucial for cultural responsiveness in disability support: service providers' competence and commitment to person centred disability services. They did not particularly mention bilingual staff, which is usually highlighted in practices for cultural responsiveness (Robertson & Travaglia, 2015;Settlement Services International, 2018Sharma et al, 2019;Torres et al, 2014). They said that arranging staff who share the same language or cultural background was important, and they perceived as a demonstration of service providers' respect of their cultural diversity, but not a definitive determinant of cultural responsiveness.…”

Community Health Workers Can Provide Psychosocial Support to the People During COVID-19 and Beyond in Low- and Middle- Income Countries

“…Recent research has demonstrated that CHWs are effective in improving the accessibility and acceptability of preventive care and primary health care and providing health education. In these roles they have reduced hospitalization and re-hospitalization particularly for people from disadvantaged communities (39).…”

Towards achieving the family planning targets in the African region: a rapid review of task sharing policies

“…On the other hand, lack of motivation and absenteeism of health care providers in impoverished countries widens the gap in quality family planning services [ 17 ]. In the bid to assuage human resource shortages, many countries have started to train less experienced health workers perform tasks that should otherwise be performed by qualified doctors or other highly-trained healthcare workers [ 18 ].…”