Rex Justin, Fifer Nichole, Johnson-Webb Karen D, Menich Maddi, Horn Alyissa, Salamone Carly, T Renzhofer Pappada Holly, Arsene Camelia, Martin Crystal, Cunningham Malcolm
Political Science, Bowling Green State University, Bowling Green, Ohio, USA.
Center for Regional Development, Bowling Green State University, Bowling Green, Ohio, USA.
Health Equity. 2024 Jul 10;8(1):469-479. doi: 10.1089/heq.2024.0038. eCollection 2024.
This study examines whether being a client in the Northwest Ohio Pathways HUB program reduces stress and improves mental wellbeing for perinatal mothers. The HUB works to improve health by connecting mothers to community health workers (CHWs) who assess mothers' risk factors and connect them to evidence-based care pathways to reduce known risks associated with adverse birth outcomes.
A one-time survey of 119 mothers in the program and monthly semi-structured interviews with 41 mothers, totaling 220 interviews.
Almost all mothers reported significantly reduced stress after joining the program. The majority also reported an improved sense of safety, security, and hope. Interviews show additional moderate reductions in stress over time while being a program client. Interviews also indicate that mothers' relationship with their CHW is key to these improvements: CHW provide social-emotional support, access to tangible goods, and help navigating social service bureaucracies.
The results support the broader literature on the health benefits of community health workers and address identified gaps within the literature, which has infrequently studied CHWs in the perinatal context.
CHWs may be one way to address racial inequity in birth outcomes linked to infant mortality, given research on the links between inequitable exposure to stressors, the impacts of racism-induced stress, and preterm and low birth weight babies. Further, the findings indicate the need to better support CHWs, and the programs that utilize them, with increased funding, insurance reimbursement, and certification.
本研究探讨了参与俄亥俄州西北部途径中心项目是否能减轻围产期母亲的压力并改善其心理健康。该中心通过将母亲与社区卫生工作者（CHW）联系起来，努力改善健康状况。社区卫生工作者会评估母亲的风险因素，并将她们与基于证据的护理途径相连接，以降低与不良分娩结果相关的已知风险。
对该项目中的119名母亲进行了一次性调查，并对41名母亲进行了每月一次的半结构化访谈，共进行了220次访谈。
几乎所有母亲都报告说，加入该项目后压力显著减轻。大多数母亲还表示安全感、保障感和希望感有所增强。访谈显示，作为项目参与者，随着时间的推移，压力会进一步适度减轻。访谈还表明，母亲与社区卫生工作者的关系是这些改善的关键：社区卫生工作者提供社会情感支持、获取有形物品的途径，并帮助她们应对社会服务官僚机构的问题。
研究结果支持了关于社区卫生工作者对健康有益的更广泛文献，并填补了文献中已确定的空白，此前该文献很少研究围产期背景下的社区卫生工作者。
鉴于有研究表明压力源暴露不平等、种族主义引发的压力影响与早产和低体重儿之间存在联系，社区卫生工作者可能是解决与婴儿死亡率相关的出生结果方面种族不平等问题的一种方式。此外，研究结果表明需要通过增加资金、保险报销和认证来更好地支持社区卫生工作者及其所在的项目。
