University of Illinois at Chicago, School of Public Health, 1603 W Taylor Street, Chicago, IL, 60612, USA.
University of Illinois at Chicago, Institute for Health Research and Policy, 1747 West Roosevelt Road, Chicago, IL, 60608, USA.
BMC Health Serv Res. 2022 Dec 27;22(1):1587. doi: 10.1186/s12913-022-08723-7.
Community health workers (CHW) have grown in prominence within the healthcare sector, yet there is no clear consensus regarding a CHW's role, purpose, and value within health systems. This lack of consensus has the potential to affect how CHWs are perceived, utilized, and ultimately integrated within the healthcare sector. This research examines clinical care teams that currently employ CHWs to (1) understand how members of the care team perceive CHWs' purpose and value, and (2) consider how perceptions of CHWs are related to CHW integration within health care teams.
Researchers conducted a qualitative descriptive multiple embedded case study at the University of Illinois at Chicago's Hospital and Health Science System (UI Health). The embedded subunits of analysis were teams within UI Health that are currently employing CHWs to assist with the provision of clinical care or services to patients. Data were collected via semi-structured interviews and document review.
In total, 6 sub-units were enrolled to participate, and 17 interviews were conducted with CHWs (n = 9), and administrators or health care providers (n = 8). Reported perceptions of CHWs were inconsistent across respondents. CHWs roles were not always understood, and the CHW's purpose and value was perceived differently by different members of the care team. Moreover, evaluation metrics did not always capture CHWs' value to the health care system. In some cases, care teams were more aligned around a shared understanding of the CHW's roles and purpose within the care team. When perceptions regarding CHWs were both positive and aligned, respondents reported higher levels of integration within the healthcare system.
Alignment in a care team's perception of a CHW's role, purpose, and value within the health system could play an important role in the integration of CHWs within healthcare teams.
社区卫生工作者（CHW）在医疗保健领域的地位日益突出，但对于 CHW 在卫生系统中的角色、目的和价值，尚未达成明确共识。这种共识的缺乏有可能影响到人们对 CHW 的看法、利用方式，以及最终 CHW 在医疗保健领域的整合方式。本研究考察了目前雇用 CHW 的临床护理团队，以了解护理团队成员如何看待 CHW 的目的和价值，以及考虑如何将对 CHW 的看法与 CHW 在医疗保健团队中的整合联系起来。
研究人员在伊利诺伊大学芝加哥分校的医院和健康科学系统（UI Health）进行了一项定性描述性多嵌入式案例研究。分析的嵌入式子单元是 UI Health 中目前雇用 CHW 协助向患者提供临床护理或服务的团队。数据通过半结构化访谈和文件审查收集。
共有 6 个小组参加了研究，对 9 名 CHW 和 8 名管理人员或医疗保健提供者进行了 17 次访谈。受访者对 CHW 的看法不一致。CHW 的角色并不总是被理解，而且不同的护理团队成员对 CHW 的目的和价值有不同的看法。此外，评估指标并不总能捕捉到 CHW 对医疗保健系统的价值。在某些情况下，护理团队在对 CHW 在护理团队中的角色和目的的共同理解上更加一致。当对 CHW 的看法既积极又一致时，受访者报告了在医疗保健系统中更高水平的整合。
在护理团队对 CHW 在卫生系统中的角色、目的和价值的看法上保持一致，可能在 CHW 整合到医疗保健团队中发挥重要作用。
