Columbia University Mailman School of Public Health, New York, NY, USA.
Columbia University Irving Medical Center, New York, NY, USA.
J Prim Care Community Health. 2024 Jan-Dec;15:21501319241234478. doi: 10.1177/21501319241234478.
Addressing family psychosocial and mental health needs in the perinatal and early childhood period has a significant impact on long-term maternal and child health and is key to achieving health equity. We aimed to (1) describe and evaluate the role of an Early Childhood Community Health Worker (EC-CHW) to address psychosocial needs and improve psychosocial well-being for families in the perinatal period, and (2) examine factors associated with completion of goals.
An EC-CHW program was modeled after an existing hospital CHW program for children with special healthcare needs and chronic disease. An evaluation was conducted using repeated measures to assess improvements in psychosocial outcomes such as family stress and protective factors after participating in the EC-CHW program. Linear regression was also used to assess factors associated with completion of goals.
Over a 21-month period (January 2019-September 2020), 161 families were referred to the EC-CHW. The most common reasons for referral included social needs and navigating systems for child developmental and behavioral concerns. There were high rates of family engagement in services (87%). After 6 months, families demonstrated statistically significant improvements in protective factors including positive parenting knowledge and social support. Only 1 key predictor variable, maternal depression, showed significant associations with completion of goals in the multivariable analysis.
This study demonstrated the need for, and potential impact of an EC-CHW in addressing psychosocial and mental health needs in the perinatal period, and in a primary care setting. Impacts on protective factors are promising.
满足围产期和儿童早期的家庭心理社会和心理健康需求对长期母婴健康有重大影响,是实现健康公平的关键。我们旨在:(1) 描述和评估幼儿社区卫生工作者 (EC-CHW) 的作用,以满足围产期家庭的心理社会需求并改善其心理社会福祉;(2) 研究与目标完成相关的因素。
以现有的儿童特殊医疗需求和慢性病医院 CHW 项目为蓝本,建立了 EC-CHW 项目。采用重复测量法进行评估,以评估在参加 EC-CHW 项目后心理社会结果(如家庭压力和保护因素)的改善情况。还使用线性回归来评估与目标完成相关的因素。
在 21 个月的时间里(2019 年 1 月至 2020 年 9 月),向 EC-CHW 转介了 161 个家庭。转介的最常见原因包括社会需求和为儿童发育和行为问题寻求系统支持。家庭对服务的参与率很高(87%)。6 个月后,家庭在保护因素方面表现出统计学上显著的改善,包括积极的育儿知识和社会支持。只有一个关键预测变量,即产妇抑郁,在多变量分析中与目标完成有显著关联。
这项研究表明,在围产期和初级保健环境中,EC-CHW 可以满足心理社会和心理健康需求,并且具有潜在的影响。对保护因素的影响很有希望。