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对支持社区卫生工作者与社会工作者有效协作的多层次因素的质性探索

A Qualitative Exploration of Multi-level Factors that Support Effective Community Health Worker-Social Worker Collaboration.

作者信息

Monga Nakra Nidhi, Petruzzi Liana J, Diller Alexander B, Smithwick Julie, Lee Lily, Wilkinson Geoff, Collier Joshua, Chang Sarah

机构信息

Johns Hopkins University.

American University.

出版信息

Res Sq. 2025 Jun 13:rs.3.rs-6733746. doi: 10.21203/rs.3.rs-6733746/v1.

Abstract

BACKGROUND

Interdisciplinary collaboration is critical for improving healthcare delivery through coordinated care and streamlined healthcare navigation. Community health workers (CHWs) and social workers (SWs) are uniquely positioned to address the needs of individuals with complex social and health challenges. Despite the integration of CHWs and SWs into health and community settings, there is a paucity of literature on what facilitates successful collaboration between these two workforces. This qualitative study, conducted from April 2022 to June 2023, explores multilevel factors related to CHW-SW collaboration in health and community settings.

METHODS

We conducted eight, 90-minute virtual focus groups with CHWs (n = 20) and SWs (n = 17) collaborating in four healthcare and community health settings across the United States (California, Texas, New Jersey, and South Carolina). Focus groups were conducted between April 2022 and June 2023.

RESULTS

Themes were thematically organized according to the socio-ecological model. Individual and relationship-level factors included: roles and scopes of practice, communication, mutual respect, supportive supervision, and power dynamics. Organizational and community-level factors comprised: commitment to equity, leadership buy-in, standardized training, clear workflows, and shared documentation and physical space. Societal-level factors included: power dynamics, supportive policies and sustainable funding.

CONCLUSIONS

Findings highlighted that CHW-SW collaboration can promote patient-centered care and address social determinants of health when both workforces are well integrated in healthcare systems. Key organizational commitments, community rapport, and relational dynamics should be established to optimize interdisciplinary collaboration and advance health equity.

摘要

背景

跨学科合作对于通过协调护理和简化医疗导航来改善医疗服务至关重要。社区卫生工作者(CHW)和社会工作者(SW)在满足具有复杂社会和健康挑战的个人需求方面具有独特的地位。尽管社区卫生工作者和社会工作者已融入卫生和社区环境,但关于促进这两支工作队伍成功合作的因素的文献却很少。这项定性研究于2022年4月至2023年6月进行,探讨了卫生和社区环境中与社区卫生工作者-社会工作者合作相关的多层次因素。

方法

我们与在美国四个医疗和社区卫生环境(加利福尼亚州、得克萨斯州、新泽西州和南卡罗来纳州)合作的社区卫生工作者(n = 20)和社会工作者(n = 17)进行了八次90分钟的虚拟焦点小组讨论。焦点小组讨论于2022年4月至2023年6月期间进行。

结果

根据社会生态模型对主题进行了主题组织。个人和关系层面的因素包括:角色和实践范围、沟通、相互尊重、支持性监督和权力动态。组织和社区层面的因素包括:对公平的承诺、领导层的支持、标准化培训、明确的工作流程以及共享文档和物理空间。社会层面的因素包括:权力动态、支持性政策和可持续资金。

结论

研究结果强调,当这两支工作队伍都很好地融入医疗系统时,社区卫生工作者-社会工作者合作可以促进以患者为中心的护理并解决健康的社会决定因素。应建立关键的组织承诺、社区融洽关系和关系动态,以优化跨学科合作并促进健康公平。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/99dc/12204489/481569653cf9/nihpp-rs6733746v1-f0001.jpg

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