Department of Health Law, Policy & Management, Boston University School of Public Health, 715 Albany Street, Boston, MA, 02118, USA.
Center for Innovation in Social Work and Health, Boston University School of Social Work, Boston, MA, USA.
J Community Health. 2021 Oct;46(5):951-959. doi: 10.1007/s10900-021-00978-1. Epub 2021 Mar 26.
Community health workers (CHWs) integrated in human immunodeficiency virus (HIV) care teams undertake a variety of tasks to help patients navigate health care, develop care plans, and address social needs. Given the broad role of CHWs in HIV care, we sought to understand which client attributes are associated with various dimensions of CHW satisfaction using a sample of 204 people with HIV (PWH) from various geographic regions across the United States. Multivariable linear regressions were used to determine which client attributes were associated with complete satisfaction with CHWs using 10 validated measures. The mean age of participants was 40.6 years old (SD = 12.8) and over 70% were Black or African American. Adjusted models reveal clients who were female, have marginal health literacy, or have a substance use disorder diagnosis were more likely to not be completely satisfied across multiple dimensions (p ≤ .05). Conversely, being housed and having a mental health diagnosis were associated with being more likely to be completely satisfied (p ≤ .04). Clients' sociodemographic characteristics and health conditions may be indicative of unique needs, leading to differing expectations of CHWs. CHW training modalities should consider the complex interplay of care needs based upon different client backgrounds and experiences among PWH. Addressing unique needs resulting from social determinants of health and that arise from conditions co-occurring with HIV, such as substance use disorders, should be incorporated into CHW service delivery.
社区卫生工作者（CHW）融入艾滋病毒（HIV）护理团队，承担各种任务，帮助患者了解医疗保健、制定护理计划和解决社会需求。鉴于 CHW 在 HIV 护理中的广泛作用，我们使用来自美国不同地区的 204 名 HIV 感染者（PWH）样本，试图了解哪些患者特征与 CHW 满意度的各个方面相关。使用 10 项经过验证的测量工具，多变量线性回归用于确定哪些患者特征与对 CHW 的完全满意度相关。参与者的平均年龄为 40.6 岁（SD=12.8），超过 70%是黑人或非裔美国人。调整后的模型显示，女性、边缘健康素养或物质使用障碍诊断的患者在多个维度上更不可能完全满意（p≤.05）。相反，有住房和心理健康诊断的患者更有可能完全满意（p≤.04）。患者的社会人口统计学特征和健康状况可能表明存在独特的需求，从而对 CHW 产生不同的期望。CHW 培训模式应考虑到不同患者背景和经历之间的复杂护理需求相互作用。应将源自健康的社会决定因素的独特需求以及与 HIV 同时发生的疾病（如物质使用障碍）产生的需求纳入 CHW 服务提供中。
