J Health Care Poor Underserved. 2020;31(1):370-381. doi: 10.1353/hpu.2020.0028.
Home visit programs have long been used as a means of intervention specifically among vulnerable, at-risk populations including: chronically ill, impoverished, rural, or homebound individuals. Understanding barriers and facilitators to the implementation of home visit programs is essential to inform these efforts. Home visit programs led by community health workers (CHWs) are becoming more common and pose specific challenges. The Ohio Infant Mortality Reduction Initiative is a home visit program led by CHWs with the purpose of reducing infant mortality among high-risk populations. The intervention included health education, referrals to health services, and provision of supplies and social support to expectant mothers. This study examined qualitative interviews with program managers and administrators to describe facilitators and barriers associated with this home visit program from a managerial perspective. Findings highlight the importance of initial and ongoing CHW training, appropriate caseloads, effective communication, and adequate funding, which can inform future CHW programs.
家庭访视项目长期以来一直被用作干预手段,专门针对脆弱、高危人群,包括:慢性病患者、贫困人群、农村地区或居家人员。了解家庭访视项目实施的障碍和促进因素对于指导这些努力至关重要。由社区卫生工作者(CHWs)领导的家庭访视项目越来越普遍,并且带来了特定的挑战。俄亥俄州婴儿死亡率降低倡议是一个由 CHWs 领导的家庭访视项目,旨在降低高危人群的婴儿死亡率。该干预措施包括健康教育、向卫生服务机构转介以及向孕妇提供用品和社会支持。本研究通过对项目管理人员的定性访谈,从管理角度描述了与该家庭访视项目相关的促进因素和障碍。研究结果强调了初始和持续的 CHW 培训、适当的工作量、有效的沟通和充足的资金的重要性,这可以为未来的 CHW 项目提供信息。