Adams Leslie B, Richmond Jennifer, Watson Sable N, Cené Crystal W, Urrutia Rachel, Ataga Onome, Dunlap Phenesse, Corbie-Smith Giselle
University of North Carolina at Chapel Hill, NC, USA.
Johns Hopkins University, Baltimore, MD, USA.
Health Educ Behav. 2021 Aug;48(4):516-531. doi: 10.1177/1090198120959326. Epub 2020 Oct 14.
In recent years, community health workers (CHWs) have emerged as key stakeholders in implementing community-based public health interventions in racially diverse contexts. Yet little is known about the extent to which CHW training curriculums influence intervention effectiveness in marginalized racial and ethnic minority communities. This review summarizes evidence on the relationship between CHW training curricula and intervention outcomes conducted among African American and Latinx populations. We conducted a literature search of intervention studies that focused on CHW public health interventions in African American and Latinx populations using PubMed, PsycINFO, ERIC, CINAHL, EMBASE, and Web of Science databases. Included studies were quantitative, qualitative, and mixed methods studies employed to conduct outcome (e.g., blood pressure and HbA1c) and process evaluations (e.g., knowledge and self-efficacy) of CHW-led interventions. Out of 3,295 articles from the database search, 36 articles met our inclusion criteria. Overall, the strength of evidence linking specific CHW training curricula components to primary intervention health outcomes was weak, and no studies directly linked outcomes to specific characteristics of CHW training. Studies that described training related to didactic sessions or classified as high intensity reported higher percentages of positive outcomes compared to other CHW training features. These findings suggest that CHW training may positively influence intervention effectiveness but additional research using more robust methodological approaches is needed to clarify these relationships.
近年来，社区卫生工作者（CHWs）已成为在种族多样化背景下实施基于社区的公共卫生干预措施的关键利益相关者。然而，对于社区卫生工作者培训课程在多大程度上影响边缘化种族和少数民族社区的干预效果，人们知之甚少。本综述总结了关于非裔美国人和拉丁裔人群中社区卫生工作者培训课程与干预结果之间关系的证据。我们使用PubMed、PsycINFO、ERIC、CINAHL、EMBASE和Web of Science数据库，对聚焦于非裔美国人和拉丁裔人群中社区卫生工作者公共卫生干预措施的干预研究进行了文献检索。纳入的研究包括用于对社区卫生工作者主导的干预措施进行结果（如血压和糖化血红蛋白）和过程评估（如知识和自我效能）的定量、定性和混合方法研究。在数据库搜索得到的3295篇文章中，有36篇符合我们的纳入标准。总体而言，将特定的社区卫生工作者培训课程组成部分与主要干预健康结果联系起来的证据力度较弱，且没有研究将结果直接与社区卫生工作者培训的特定特征联系起来。与其他社区卫生工作者培训特点相比，描述与讲授课程相关培训或归类为高强度培训的研究报告的积极结果百分比更高。这些发现表明，社区卫生工作者培训可能会对干预效果产生积极影响，但需要使用更有力的方法进行更多研究来阐明这些关系。
