Evaluating community healthworkers' attributes, roles, and pathways of action in immigrant communities

PREVENTIVE MEDICINE

卷:103

Article

Islam, Nadia¹  Shapiro, Ephraim²  Wyatt, Laura¹  Riley, Lindsey³  Zanowiak, Jennifer¹  Ursua, Rhodora⁴  Trinh-Shevrin, Chau¹ 

[1] NYU, Sch Med, Dept Populat Hlth, 550 First Ave,VZN 843, New York, NY 10016 USA

[2] Ariel Univ, Dept Hlth Management, Ariel, Israel

[3] Michael J Fox Fdn Parkinsons Res, New York, NY USA

[4] Asian Pacific Partnerships Empowerment Advocacy &, Oakland, CA USA

关键词: Community-based participatory research;    Minority health;    Immigrant health;    Program evaluation;    Health promotion;    Community health workers;   

DOI  :  10.1016/j.ypmed.2017.07.020

来源: Elsevier

【 摘 要 】

Community health workers (CHWs) are uniquely positioned to improve health outcomes in immigrant communities; however, research on appropriate metrics for evaluating CHWattributes and mechanisms of effectiveness are limited. The objective of this paper is to characterize CHWattributes and pathways of action using adapted measures, develop a scale using these measures, and explore how findings can inform future CHW research and practice. The study analyzed pre-and post-intervention group data from one quasi-experimental and three randomized controlled-design parent trials assessing the impact of CHW-led group and individual health coaching on various health outcomes in four New York City immigrant communities. We conducted descriptive, bi-variate and principal components analysis to develop a 13-item scale assessing CHW attributes, roles, and pathways of action. The sample included 437 individuals completing the intervention armof a CHWstudy. We found CHWs were reported to affect change through a number of mechanisms and participants expressed substantial communal concordance with the CHWs in terms of country of birth, language, and culture. Principal components analysis with promax rotation identified 13 itemswith three factors and high Cronbach's alphas: 1) valued interpersonal attributes of the CHW(alpha=0.784); 2) CHWas a bridge to health and non-health resources (alpha=0.857); and 3) providing accessibility beyond health providers (alpha=0.904). Socio-demographic characteristics and differences in CHWpathways of actionwere identified by community. Study findings can guide improved selection and training of CHWs. Further, measures identified in the principal components analysis can be used to guide future CHWevaluation efforts. (C) 2017 Published by Elsevier Inc.

【 授权许可】

Free