Kiriakopoulos Elaine T, Jobst Barbara, Murray Anna, Sykes Carly, Lenz Suzanne, Dawson Trina, Kaden Sarah, Chu Felicia
Geisel School of Medicine, Dartmouth College, Hanover, NH, United States.
HOBSCOTCH Institute, Dartmouth Hitchcock Medical Center, Dartmouth Health, Lebanon, NH, United States.
Front Neurol. 2025 Apr 9;16:1560077. doi: 10.3389/fneur.2025.1560077. eCollection 2025.
Substantial evidence supports community health worker (CHW) interventions lead to improved health outcomes, but health professionals' perceptions of CHW roles and effectiveness may slow integration into care delivery systems. Research on CHWs as members of specialty care teams in clinical settings, especially in the epilepsy field, is limited.
We conducted semi-structured interviews between April and October 2022 to explore perceptions of multidisciplinary clinicians ( = 12; physicians, nurses, social workers) based at five New England epilepsy centers about the potential for successful CHW integration on specialist epilepsy center care teams. Transcripts were analyzed using a mixed inductive and deductive thematic approach.
Themes that emerged included: (1) limited epilepsy clinician awareness of the CHW role and minimal experience working with a CHW; (2) limited clinician knowledge of how to recruit CHWs; (3) preference for CHW roles and responsibilities in epilepsy centers being focused on social determinants of health (4) clinician uncertainty around scope of CHW training and supervision; (5) unknown funding mechanisms for CHW integration in epilepsy centers; (6) knowledge of care gaps in addressing social determinants of health needs by epilepsy centers; (7) openness by epilepsy center care team members to CHW integration; and (8) environment and collaborative culture at epilepsy centers.
Despite limited knowledge and experience regarding CHW roles and mechanisms for recruiting and sustaining CHW positions, the multidisciplinary clinicians interviewed valued the potential benefits of CHWs in an epilepsy center and endorsed a need to better address patients' unmet social determinants of health needs.
大量证据表明社区卫生工作者（CHW）干预可改善健康结果，但卫生专业人员对CHW角色和有效性的认知可能会减缓其融入医疗服务体系的进程。关于CHW作为临床环境中专科护理团队成员的研究有限，尤其是在癫痫领域。
我们在2022年4月至10月期间进行了半结构化访谈，以探讨新英格兰地区五个癫痫中心的多学科临床医生（n = 12；医生、护士、社会工作者）对CHW成功融入专科癫痫中心护理团队可能性的看法。使用归纳和演绎相结合的主题分析方法对访谈记录进行分析。
出现的主题包括：（1）癫痫临床医生对CHW角色的认识有限，与CHW合作的经验极少；（2）临床医生对如何招募CHW的了解有限；（3）倾向于将癫痫中心CHW的角色和职责聚焦于健康的社会决定因素；（4）临床医生对CHW培训和监督范围存在不确定性；（5）癫痫中心CHW融入的资金机制不明；（6）了解癫痫中心在满足健康社会决定因素需求方面的护理差距；（7）癫痫中心护理团队成员对CHW融入持开放态度；（8）癫痫中心的环境和协作文化。
尽管对CHW角色以及招募和维持CHW职位的机制了解有限且经验不足，但接受访谈的多学科临床医生重视CHW在癫痫中心的潜在益处，并认可需要更好地满足患者未得到满足的健康社会决定因素需求。
