Center for Health Outcomes and Policy Evaluation Studies (HOPES), The Ohio State University College of Public Health, 381 Cunz Hall, 1841 Neil Avenue, Columbus, OH, 43210, USA.
Division of Health Services Management and Policy, The Ohio State University College of Public Health, Columbus, OH, 43210, USA.
J Community Health. 2023 Jun;48(3):430-445. doi: 10.1007/s10900-022-01183-4. Epub 2023 Jan 6.
Community health workers (CHWs), or promotores de salud, have long played a role in health promotion, but the COVID-19 pandemic has brought renewed attention to the functions, sustainability, and financing of CHW models. ¡Andale! ¿Que Esperas? was a 12-month (June 2021-May 2022) campaign that expanded the CHW workforce to increase COVID-19 vaccination rates in structurally vulnerable, Latinx communities across California. This mixed-methods evaluation aims to elucidate (1) the role of CHWs in COVID-19 response, recovery, and rebuilding and (2) the importance, needs, and perils of CHW models in the COVID-19 era and beyond. CHWs facilitated 159,074 vaccinations and vaccine appointments by countering mis/disinformation, addressing mental health and social needs, building digital competencies, and meeting people where they are, all of which expanded access and instilled confidence in the COVID-19 vaccine. CHWs' success in engaging the community lies in their shared lived experience as well as their accessibility and recognition in the community, enabling their role in both immediate response and long-term recovery. Funding instability imperils the advances made by CHWs, and efforts are needed to institutionalize the CHW workforce with sustainable funding models. While Medicaid reimbursement models exist in some states, these models are often limited to healthcare services, overlooking a critical function of the CHW model: building community resilience and mobilizing the community for social change.
社区卫生工作者（CHWs），或健康促进者，长期以来一直在促进健康方面发挥作用，但 COVID-19 大流行使 CHW 模式的功能、可持续性和融资再次受到关注。¡Andale！¿Que Esperas？是一项为期 12 个月的（2021 年 6 月至 2022 年 5 月）活动，该活动扩大了 CHW 队伍，以提高加利福尼亚州结构脆弱的拉丁裔社区的 COVID-19 疫苗接种率。这项混合方法评估旨在阐明（1）CHWs 在 COVID-19 应对、恢复和重建中的作用，以及（2）CHW 模式在 COVID-19 时代及以后的重要性、需求和危险。CHWs 通过对抗错误/虚假信息、解决心理健康和社会需求、建立数字能力以及在人们所在的地方满足他们的需求，促进了 159,074 次疫苗接种和疫苗预约，所有这些都扩大了获取机会，并增强了人们对 COVID-19 疫苗的信心。CHWs 在参与社区方面的成功在于他们作为社区成员的共同生活经历，以及他们在社区中的可及性和认可度，这使他们能够在即时反应和长期恢复中发挥作用。资金不稳定危及 CHWs 取得的进展，需要努力通过可持续的资金模式将 CHW 队伍制度化。虽然一些州存在医疗补助报销模式，但这些模式通常仅限于医疗服务，忽视了 CHW 模式的一个关键功能：建立社区复原力和动员社区进行社会变革。
