Global Center for Applied Health Research, School of Social Work, Arizona State University, 411 North Central Avenue, Suite 720, Mail Code 4320, Phoenix, AZ, 85004, USA.
J Community Health. 2023 Jun;48(3):398-413. doi: 10.1007/s10900-022-01182-5. Epub 2022 Dec 19.
This study documents the pivotal role that Community Health Workers (CHW) played while supporting underserved Latinx communities affected by COVID-19-related health inequities. With the support of CHWs' agencies historically serving three Latinx-dense counties in Arizona, we recruited CHWs who participated in a state-wide COVID-19 testing project. Using phenomenology and narrative qualitative research methods, five focus groups were facilitated in Spanish between August and November 2021. Bilingual research team members conducted the analysis of the Spanish verbatim transcripts and CHWs reviewed the results for validity. Three interconnected themes reflected the CHWs experiences: (1) CHWs as puentes/bridges with deep community embeddedness through shared experiences and social/cultural context, (2) CHWs as communication brokers and transformational agents, playing a pivotal role in responding to the health and socioeconomic challenges posed by the COVID-19 pandemic, (3) CHWs satisfaction and frustration due to their dual role as committed community members but unrecognized and undervalued frontline public health workers. These findings emphasize the CHWs' commitment towards supporting their communities, even amidst the stressors of the pandemic. It is important to continue to integrate the role of CHWs into the larger healthcare system as opposed to relegating them to short term engagements as was the case during the COVID-19 pandemic. This article provides a set of practice, policy, and future research recommendations, emphasizing the need to allocate greater budgetary and training resources in support of CHWs.
本研究记录了社区卫生工作者(CHW)在支持受 COVID-19 相关健康不平等影响的服务不足的拉丁裔社区方面所发挥的关键作用。在历史上为亚利桑那州三个拉丁裔人口密集县服务的 CHW 机构的支持下,我们招募了参与全州 COVID-19 检测项目的 CHW。我们采用现象学和叙事定性研究方法,于 2021 年 8 月至 11 月期间以西班牙语组织了五场焦点小组讨论。双语研究小组成员对西班牙语逐字记录进行了分析,CHW 对结果进行了有效性审查。三个相互关联的主题反映了 CHW 的经验:(1)CHW 作为与社区紧密相连的 puentes/桥梁,通过共同的经历和社会/文化背景建立联系;(2)CHW 作为沟通经纪人以及变革推动者,在应对 COVID-19 大流行带来的健康和社会经济挑战方面发挥了关键作用;(3)CHW 因作为忠诚的社区成员的双重角色而感到满意,同时又因作为未被认可和低估的一线公共卫生工作者而感到沮丧。这些发现强调了 CHW 对支持社区的承诺,即使在疫情的压力下也是如此。重要的是,要继续将 CHW 的角色融入更大的医疗保健系统,而不是像在 COVID-19 大流行期间那样将其限制在短期参与中。本文提供了一套实践、政策和未来研究建议,强调需要分配更多的预算和培训资源来支持 CHW。