La Clínica - Casa del Sol, 1501 Fruitvale Ave, Oakland, California, 94601, USA.
UT Health School of Public Health in Brownsville, Division of Health Promotion & Behavioral Sciences and Hispanic Health Research Center, One West University Blvd, Brownsville, TX, 78520, USA.
Int J Equity Health. 2018 Feb 5;17(1):19. doi: 10.1186/s12939-018-0729-9.
Interventions that promote healthier lifestyles among Latinos often involve community health workers (CHWs). CHWs can effectively advocate for healthier lifestyles and may be pivotal in addressing such mental health conditions as depression and anxiety. The goal of this study was to characterize the relationship dynamics between Latino participants and CHWs, from the participant's perspective. We aimed to determine if CHW-delivered community interventions effected behavior change, especially among participants who reported anxiety and depression.
Semi-structured interviews were conducted with a purposive sample of 28 Latino participants that was based on a mental health scoring strata. Participants completed a lifestyle intervention that included multiple home visits from CHWs to promote physical activity and healthful food choice. Interviews were conducted in the participant's preferred language (English or Spanish). Transcribed interviews were analyzed using a grounded theory approach until concept saturation was achieved.
The sample was primarily female (82%), lower socioeconomic status (64%), and mean age of 50 years. Participants discussed the rapport building and professionalism of CHWs as a feature that facilitated strong, positive relationships and lifestyle behavior changes. Participants described how CHWs patterned their change approaches, which were similar to commonly used therapeutic techniques in the treatment of anxiety and depression. While anxiety and depression were described as having an impact on behavior change, most, but not all, participants who reported negative mood states said that the CHW relationship helped in changing that state to some extent.
Participants' perceptions indicated that positive personal changes were influenced by CHWs. Only participants who reported consistently poor scores for depression, anxiety or both reported negative or neutral experiences with the CHWs. This study lends qualitative support to the use of CHWs as extenders of care, particularly in areas that have a shortage of primary and mental health care providers.
促进拉丁裔人群更健康生活方式的干预措施通常涉及社区卫生工作者（CHW）。CHW 可以有效地倡导更健康的生活方式，并且可能在解决抑郁和焦虑等心理健康问题方面发挥关键作用。本研究的目的是从参与者的角度描述拉丁裔参与者与 CHW 之间的关系动态。我们旨在确定 CHW 提供的社区干预措施是否会产生行为改变，特别是在报告焦虑和抑郁的参与者中。
对基于心理健康评分分层的 28 名拉丁裔参与者进行了半结构式访谈。参与者完成了一项生活方式干预措施，其中包括 CHW 多次家访，以促进身体活动和健康食品选择。访谈以参与者首选的语言（英语或西班牙语）进行。使用扎根理论方法对转录的访谈进行分析，直到达到概念饱和。
该样本主要为女性（82%），社会经济地位较低（64%），平均年龄为 50 岁。参与者讨论了 CHW 的建立关系和专业精神，这是促进强大、积极关系和生活方式行为改变的一个特征。参与者描述了 CHW 如何模仿他们的改变方法，这些方法类似于焦虑和抑郁治疗中常用的治疗技术。虽然焦虑和抑郁被描述为对行为改变有影响，但大多数（但不是全部）报告负面情绪状态的参与者表示，CHW 关系在某种程度上帮助改变了这种状态。
参与者的看法表明，积极的个人变化受到 CHW 的影响。只有报告抑郁、焦虑或两者均有持续较差评分的参与者报告了对 CHW 的负面或中性体验。这项研究从定性上支持了 CHW 作为护理延伸者的使用，特别是在缺乏初级和心理健康保健提供者的地区。
