State of evaluation: Community health workers
State of evaluation: Community health workers
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DOI：
10.1046/j.1525-1446.2003.20403.x
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发表时间：
2003-07-01
影响因子：
2.1
通讯作者：
Sabatier, R
中科院分区：
文献类型：
--
作者：
Nemcek, MA;Sabatier, R
差异群体，特别是少数种族和族裔群体，健康状况不佳的风险更大，但在获得医疗保健方面遇到许多障碍。社区卫生工作者 (CHW) 是服务不足的社区中土著、值得信赖和尊重的成员。它们可以充当同行和卫生专业人员之间的桥梁。自 20 世纪 60 年代联邦政府首次批准使用社区卫生工作者来扩大医疗服务不足人群的医疗服务以来，社区卫生工作者的使用情况一直在波动。国家消除健康差距的要求和最近的社会经济压力已将注意力集中在使用社区卫生工作者来改善社区健康上。尽管如此，利用不足的部分原因是缺乏对社区卫生工作者概念的理解以及缺乏关于社区卫生工作者的评估文献。本文描述了社区卫生工作者的概念，提供了社区卫生工作者评估文献的总结，并提出了加强评估的质量护理指标。对与社区卫生工作者相关的评估研究的回顾为护士开始建立循证实践提供了初步的科学状况。与社区卫生工作者相关的护理质量指标是从现有的评估文献中总结出来的。提出了三个最佳实践领域（治疗联盟、降低风险和医疗保健利用）以及使用质量指标改进评估的建议。随着社区卫生资源利用率的提高，健康差距可能会缩小。
Disparity groups, especially racial and ethnic minority groups, are at greater risk for poor health yet experience numerous obstacles in accessing health care. Community health workers (CHWs) are indigenous, trusted, and respected members of the underserved community. They can serve as a bridge between peers and health professionals.Use of CHWs has fluctuated since the federal government first endorsed their use for expanded health access to the underserved in the 1960s. National demands to eliminate health disparities and recent socioeconomic pressures have focused attention on use of CHWs to improve community health. Still, underutilization exists due to, in part, a lack of understanding of the CHW concept and a dearth of evaluation literature on CHWs.This article describes the CHW concept, provides a summary of CHW evaluation literature, and suggests quality care indicators to strengthen evaluation. The review of evaluation research relating to CHWs provides a preliminary state of the science for nurses to begin building an evidence-based practice. Quality of care indicators pertinent to CHW are summarized from the existing evaluation literature. The three best practice domains (therapeutic alliance, risk reduction and health care utilization) are proposed along with suggestions for using quality indicators to improve evaluation. A reduction in health disparities can occur with enhanced CHW utilization.