Catalani Caricia E, Findley Sally E, Matos Sergio, Rodriguez Romelia
Columbia University, Mailman School of Public Health, USA.
Prog Community Health Partnersh. 2009 Fall;3(3):227-35. doi: 10.1353/cpr.0.0082.
In recent years, the community health worker (CHW) field has grown significantly in the United States, with increasing numbers, roles, and visibility of CHWs. State health department regulators, health program administrators, and community health advocates have observed this growth with uncertainty about the definition of a CHW, how CHW roles differ from those of other health professionals, CHW training needs, and the potential impact of the growing certification and accreditation regulations.
Despite the proliferation of regulatory policies, few studies have examined how regulation can most effectively support CHWs in the field. Our objective is to define CHW, identify training needs, and examine possibilities for credentialing from the perspective of CHWs in New York City.
Community-based participatory research (CBPR) was used to engage CHW leadership and gather input from CHWs in the design and conduct of the study. The academic-community-state partnership designed focus group topic guides, and conducted fifteen focus groups with CHWs in New York City. The focus group responses were analyzed using HyperResearch and formed the basis for policy recommendations to the participating partners.
We developed a consensus definition of CHW and its fundamental qualities. We identified unmet training needs in the area of core competencies. We outlined the characteristics of a credentialing process that would support and advance the work of CHWs.
CBPR enabled CHWs to have a direct voice in defining their description, roles, training, and certification preferences. This informed policy recommendations to the state, university, and CHWs through a collaborative process.
近年来,美国社区卫生工作者(CHW)领域显著发展,CHW的数量、角色及知名度都在增加。州卫生部门监管人员、卫生项目管理人员和社区卫生倡导者注意到了这一发展,但对CHW的定义、CHW角色与其他卫生专业人员角色的差异、CHW的培训需求以及日益增加的认证和认可法规的潜在影响存在不确定性。
尽管监管政策不断涌现,但很少有研究探讨监管如何能最有效地支持该领域的CHW。我们的目标是从纽约市CHW的角度定义CHW、确定培训需求并研究认证的可能性。
基于社区的参与性研究(CBPR)被用于让CHW领导层参与进来,并在研究的设计和实施过程中收集CHW的意见。学术-社区-州合作伙伴关系设计了焦点小组主题指南,并在纽约市与CHW进行了15次焦点小组讨论。使用HyperResearch对焦点小组的反馈进行分析,并形成向参与伙伴提出政策建议的基础。
我们制定了CHW及其基本素质的共识定义。我们确定了核心能力领域未满足的培训需求。我们概述了支持和推进CHW工作的认证过程的特点。
CBPR使CHW能够在定义他们的描述、角色、培训和认证偏好方面有直接发言权。这通过协作过程为向州、大学和CHW提出的政策建议提供了信息。