Evaluating community healthworkers' attributes, roles, and pathways of action in immigrant communities
Evaluating community healthworkers' attributes, roles, and pathways of action in immigrant communities
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DOI：
10.1016/j.ypmed.2017.07.020
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发表时间：
2017-10-01
影响因子：
5.1
通讯作者：
Trinh-Shevrin, Chau
中科院分区：
文献类型：
--
作者：
Islam, Nadia;Shapiro, Ephraim;Trinh-Shevrin, Chau
社区卫生工作者（CHWs）的独特定位，以改善移民社区的健康结果，然而，适当的指标评估CHWattributes和机制的有效性的研究是有限的。本文的目的是使用适应性措施描述CHW的属性和作用途径，使用这些措施制定量表，并探讨研究结果如何为未来的CHW研究和实践提供信息。该研究分析了来自一项准实验和三项随机对照设计的父母试验的干预前后组数据，这些试验评估了CHW的影响，在四个纽约市移民社区领导小组和个人进行各种健康结果的健康辅导。我们进行了描述性，双变量和主成分分析，以开发一个13项规模评估CHW的属性，作用和作用途径。样本包括437名完成CHW研究干预组的个体。我们发现，据报道，CHW通过一些机制影响变化，参与者在出生国，语言和文化方面与CHW表达了实质性的社区一致性。主成分分析与promax旋转确定了13个项目，有三个因素和高Cronbach的α：1）重视的人际属性的CHW（α =0.784）; 2）CH是一个桥梁，健康和非健康资源（α =0.857）;和3）提供超越卫生提供者的可及性（α =0.904）。社会人口学特征和CHW行动途径的差异由社区确定。研究结果可以指导改进CHW的选择和培训。此外，在主成分分析中确定的措施可用于指导未来的CHW评价工作。(C)2017由Elsevier Inc.出版
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.