Basrai Zavera K, Yoon Caroline Y, Tsosie Valerie, Bell Ronny A, Boucher Nathan A
Sanford School of Public Policy, Duke University, Durham, USA.
So'Tsoh Foundation, Window Rock, AZ, USA.
PEC Innov. 2025 Apr 30;6:100397. doi: 10.1016/j.pecinn.2025.100397. eCollection 2025 Jun.
Describe the role and benefit of Community Health Workers in American Indian communities as a novel solution to meeting home and community-based service (HCBS) needs.
Short communication based on extant literature and current policy challenges.
Community health workers (CHW) play an essential role in various healthcare settings particularly in American Indian (AI) communities working to close gaps in preventive and comprehensive healthcare accessibility. CHWs close these gaps through providing expertise in culturally oriented and familial support, educating communities on acute and chronic illnesses and wellness, and dispelling misinformation regarding health issues. However, integration and application of CHWs into home- and community-based services has limited recognition and utilization in healthcare systems and healthcare payment. Robust training/credentialing pathways and sustainable funding streams are essential for the integration of CHWs into the formalized healthcare provider team. Barriers that prevent this integration include inconsistencies in documentation, lack of stable funding, and a lack of formal professional recognition.
Previously successful models of CHW integration promote formalized training programs, professional development opportunities, earning certifications, and promoting collaboration between CHWs and providers.
Applying CHW use in HCBS can increase community wellness while mitigating impacts of health disparities in HCBS for an often-under-resourced set of communities - our nation's American Indian communities.
描述社区卫生工作者在美国印第安社区中的作用和益处，作为满足居家和社区服务（HCBS）需求的一种新解决方案。
基于现有文献和当前政策挑战进行简短交流。
社区卫生工作者（CHW）在各种医疗环境中发挥着重要作用，尤其是在美国印第安（AI）社区，致力于缩小预防性和综合性医疗服务可及性方面的差距。社区卫生工作者通过提供以文化为导向的专业知识和家庭支持、就急性和慢性疾病及健康问题对社区进行教育以及消除有关健康问题的错误信息来缩小这些差距。然而，社区卫生工作者融入居家和社区服务在医疗系统和医疗支付方面的认可度和利用率有限。强大的培训/认证途径和可持续的资金流对于将社区卫生工作者纳入正规医疗服务提供者团队至关重要。阻碍这种融入的因素包括文件记录不一致、缺乏稳定资金以及缺乏正式的专业认可。
先前成功的社区卫生工作者融入模式促进了正规培训项目、专业发展机会、获得认证以及促进社区卫生工作者与提供者之间的合作。
在居家和社区服务中应用社区卫生工作者可以提高社区健康水平，同时减轻资源往往不足的社区——我们国家的美国印第安社区——在居家和社区服务中健康差距的影响。
