School of Public Health, Loma Linda University, 24951 North Circle Drive, Loma Linda, CA, 92350, USA.
Global Health, School of Public Health, Loma Linda University, 24951 North Circle Drive, Nichol Hall, Loma Linda, CA, 92350, USA.
J Community Health. 2019 Feb;44(1):159-168. doi: 10.1007/s10900-018-0566-1.
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.
传统的社区卫生工作者（CHWs）正在将其角色扩展到临床环境中（cCHW），以支持患者的护理协调和宣传服务。我们通过评估患者和 CHW 的关键人口统计学、需求和能力，研究了整合 cCHW 的潜力。这项混合方法研究包括成人患者和 CHW，于 2016 年至 2017 年在内陆南加州进行。评估了调查数据、关键知情人访谈和焦点小组讨论，以比较患者/CHW 的核心人口统计学，并将患者确定的医疗保健需求与 CHW 确定的 cCHW 服务能力进行对比。使用双样本独立 t 检验和 Pearson 卡方检验对定量数据进行描述性和双变量评估。使用预先确定的和标准的扎根理论方法对定性数据进行编码，以提取出现的主题。患者和 CHW 在年龄、教育和收入方面非常相似，但在性别、种族、美国代际和婚姻状况方面存在显著差异。对于所有患者和 CHW 表现出显著差异的医疗保健相关服务，CHW 认为自己有能力提供服务的可能性大于患者对服务的需求。患者和 CHW 对 cCHW 的期望重叠。尽管患者和 CHW 存在一些差异，但他们对 cCHW 整合有许多共同的期望。这些信息对于进一步制定 cCHW 培训计划至关重要，并强调了教育患者了解这种令人兴奋的新医疗服务形式的必要性。cCHW 在临床护理团队和社区中的积极作用可能会扩大患者获得预防保健的机会，提高护理质量，并最大限度地减少健康不平等。
