Yousefi Nooraie Reza, Naghibi Deniz, Hernández-Torres Ruthmarie, Cupertino Paula
University of Rochester, Rochester, NY, USA.
Memorial Sloan Kettering Cancer Center, New York, NY, USA.
J Prim Care Community Health. 2025 Jan-Dec;16:21501319241306706. doi: 10.1177/21501319241306706.
Community Health Workers (CHWs) are members of healthcare teams that are integrated in, and often share language, beliefs, and lived experiences with their communities. They use their formal and informal social networks to promote healthy behavior, to connect community members to resources, and to build more resilient community networks. We propose a framework to conceptualize CHW interventions aiming to operationalize and optimize CHW social relations and networks. CHW-mediated network interventions can focus on the dissemination and diffusion of health messages, using the channels of trust and formal and informal relations, as well as, engaging communities to enhance the cascade of spreading/diffusion. Network interventions can also focus on network-building and community dialog, relying on the role of CHWs in bringing the community members together in facilitating conversation, promoting social justice and inclusion, and mobilizing the community in collective action. In addition, the network interventions can aim for boundary-spanning and bridging activities, to facilitate the community's access to health services and external resources, as well as bringing the community voice to health systems to influence priorities and policies. Similar to any other complex interventions, CHW network interventions should be fine-tuned and adapted to local and community needs, capacities, and network structures, and actively involve community members in the conceptualization, delivery, and evaluation.
社区卫生工作者（CHWs）是医疗团队的成员，他们融入所在社区，并且通常与社区成员使用相同的语言、拥有共同的信仰和生活经历。他们利用自身正式和非正式的社交网络来促进健康行为、将社区成员与资源相连接，并建立更具韧性的社区网络。我们提出了一个框架，用以将社区卫生工作者干预措施概念化，旨在实施并优化社区卫生工作者的社会关系和网络。由社区卫生工作者介导的网络干预措施可以聚焦于健康信息的传播与扩散，利用信任渠道以及正式和非正式关系，同时促使社区参与，以加强传播/扩散的级联效应。网络干预措施还可以聚焦于网络建设和社区对话，依靠社区卫生工作者在促使社区成员聚集在一起以推动对话、促进社会正义与包容以及动员社区采取集体行动方面所发挥的作用。此外，网络干预措施可以致力于跨界和桥梁活动，以便利社区获得卫生服务和外部资源，同时将社区声音带入卫生系统，以影响重点工作和政策。与任何其他复杂干预措施一样，社区卫生工作者网络干预措施应进行微调，以适应当地和社区的需求、能力及网络结构，并积极让社区成员参与到概念化、实施和评估过程中。
