Patient and Community Health Worker Perceptions of Community Health Worker Clinical Integration

Abstract

Traditional community health workers (CHWs) are expanding their role into clinical settings (cCHW) to support patients with care coordination and advocacy services. We investigated the potential to integrate cCHWs, via evaluation of patients' and CHWs' key demographics, needs, and abilities. This mixed-methods study, including adult patients and CHWs, was conducted in the Inland Valley of Southern California, between 2016 and 2017. Survey data, key informant interviews, and focus group discussions were evaluated to compare patient/CHW core demographics, and contrast patient-identified healthcare needs against CHW-identified cCHW service capabilities. Quantitative data were evaluated descriptively and bi-variably using two-sample independent t tests and Pearson's Chi square tests. Qualitative data were coded for emerging themes using a priori and standard grounded theory methods. Patients and CHWs were significantly similar in age, education, and income, but significantly differed in gender, race, United States generation, and marital status. For all healthcare-related services in which patients and CHWs exhibited significant differences, the odds CHWs perceived themselves capable of performing services were greater than patients' stated need of services. Patients and CHWs overlapped regarding their expectations of cCHWs. Although patients and CHWs differed somewhat, they shared many of the same expectations for cCHW integration. This information is critical to further contextualize cCHW training programs and emphasizes the need to education patients about this exciting new form of healthcare delivery. The active role of cCHWs in the clinical care team and the community may expand patient access to preventive healthcare, improve care quality, and minimize health inequities.

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

“…This study provides evidence that integrating a CHW intervention into primary care in a safety net setting improves patients' satisfaction in accessing health services and community resources, and overall health outcomes. Speci cally, this study suggests the effectiveness of the CHW program in the areas of increasing health knowledge and improving access to needed health services and health outcomes, which aligns with previous research [21,22,23,24].…”

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

“…12 This study suggests the effectiveness of the CHW program in the areas of increasing health knowledge and improving access to needed health services and health outcomes, which aligns with previous research. [13][14][15][16] In addition, the results of this study demonstrate the positive effect of professionalism of the CHW in enhancing patient self-efficacy and trust. With the help of the CHW, patients acknowledged that they built up skills and confidence to achieve their target goals by modifying their lifestyle behaviors, which is consistent with earlier research that documented the benevolent relationship between CHW and community.…”

Community health workers' perspectives on integrating into school settings to support student health

“…In school settings, this is akin to participants' suggestion that school leaders disseminate information about the CHW to the school community. Such introductions are important to prepare school members to optimally utilize the CHW, as CHWs have been shown to have greater readiness than clients and higher odds of anticipating themselves capable of performing services than clients reported a need for such services ( 45 , 46 ).…”