Trout Kate E, Chaidez Virginia, Ern Jessica, Bremer Mark, Karsting Kathy, Su Dejun
Department of Health Sciences, College of Health Sciences, University of Missouri-Columbia, Columbia, MO, USA.
Institute for Rehabilitation Science and Engineering, Madonna Rehabilitation Hospitals, Lincoln, USA.
J Community Health. 2024 Apr;49(2):257-266. doi: 10.1007/s10900-023-01289-3. Epub 2023 Oct 17.
Despite the growing importance of community health workers (CHWs) in public health, it has been difficult to characterize the roles and scope of services for this workforce in part because of the variability in the employment status of CHWs, ranging from full-time, part-time, to volunteer. Based on analysis of survey data from a statewide assessment of the CHW workforce in Nebraska (n = 142) conducted between 2019 and 2020, the proportions of CHWs who worked full-time, part-time, or volunteer were respectively 64%, 12%, and 21%. Over three quarters (76.7%) of volunteer CHWs were primarily working with Hispanic communities, as compared to less than 30% among full-time and part-time CHWs. About 80% of volunteer CHWs received training before becoming a CHW, substantially higher than the corresponding proportions among full-time (46.2%) and part-time CHWs (52.9%). In terms of tasks performed, the proportion of volunteer CHWs who provided health screenings (70%) were much higher than full or part-time CHWs (41.8% and 11.8% respectively, p < 0.001); whereas the latter two groups were significantly more likely than volunteer CHWs to provide other tasks such as coordinating care, health coaching, social support, transportation, interpretation, data collection, advocacy, and cultural awareness. Volunteer CHWs may hold potential for serving non-Hispanic communities. Future development of the CHW workforce can benefit from understanding and leveraging the significant differences in roles and scope of services among CHWs with various employment statuses.
尽管社区卫生工作者（CHW）在公共卫生领域的重要性日益凸显，但由于CHW就业状况的多样性，包括全职、兼职和志愿者，很难界定这一劳动力群体的角色和服务范围。基于对2019年至2020年期间内布拉斯加州CHW劳动力进行的全州评估调查数据（n = 142）的分析，全职、兼职或志愿者身份的CHW比例分别为64%、12%和21%。超过四分之三（76.7%）的志愿者CHW主要服务于西班牙裔社区，而全职和兼职CHW中这一比例不到30%。约80%的志愿者CHW在成为CHW之前接受过培训，这一比例大幅高于全职CHW（46.2%）和兼职CHW（52.9%）的相应比例。在执行的任务方面，提供健康筛查的志愿者CHW比例（70%）远高于全职或兼职CHW（分别为41.8%和11.8%，p < 0.001）；而后两组比志愿者CHW更有可能提供其他任务，如协调护理、健康指导、社会支持、交通、口译、数据收集、宣传和文化意识。志愿者CHW可能在服务非西班牙裔社区方面具有潜力。CHW劳动力的未来发展可以从了解和利用不同就业状况的CHW在角色和服务范围上的显著差异中受益。
