Community health workers supporting emerging adults with sickle cell disease

Sadie M. Butcher , Caren Steinway , Brahadesh Sivakumar , Katherine Wu , Toyosi Oluwole , Desireé N. Williford , Sophia Jan , Symme W. Trachtenberg , Kim Smith-Whitley , Tanisha D. Belton
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Abstract

Background

Community health workers (CHWs) are vital links between communities and health systems, with CHW models facilitating positive health and life outcomes. However, little is known about CHWs’ experiences serving in these roles or their potential to support the transition to adulthood for adolescents and young adults (AYA).

Methods

Semi-structured interviews were conducted with CHWs and their supervisors from five recruitment sites affiliated with Community Health Worker and Mobile Health for Emerging Adults Transitioning Sickle Cell Disease Care (COMETS) Trial. COMETS compared the effectiveness of a CHW intervention, mobile health application, or enhanced usual care on the health-related quality of life of AYA with SCD transitioning from pediatric to adult care. To understand CHW and CHW supervisor experiences during the COMETS trial, interviews were analyzed using an integrated inductive and deductive thematic analytic approach.

Results

Three key themes emerged as interviewees described the unique aspects of the CHW role: (1) the supports for transition to adulthood that CHWs provided to patients, (2) the experiences of establishing trusting relationships with patients, and (3) the impact of the role on CHWs themselves. All interviewees reported unique contributions made by CHWs in supporting patients’ transition readiness, and CHWs expressed that participating in COMETS impacted them personally and professionally.

Conclusion

This study highlights that the CHW role is unique both in how CHWs connect with AYA and how it impacts CHWs. Health systems should explore paths for sustainable funding and workforce development for CHWs and invest in infrastructure for CHW transition programs.
支持镰状细胞病新发成人的社区卫生工作者
社区卫生工作者(CHW)是社区和卫生系统之间的重要纽带,社区卫生工作者的模式促进了积极的健康和生活结果。然而,我们对健康工作者在这些角色中的经历,以及他们支持青少年和年轻人(AYA)向成年过渡的潜力知之甚少。方法对来自社区卫生工作者和新兴成人过渡镰状细胞病护理(COMETS)试验附属的5个招聘地点的卫生工作者及其主管进行半结构化访谈。COMETS比较了CHW干预、移动健康应用或增强常规护理对儿童期SCD转为成人护理的AYA患者健康相关生活质量的影响。为了了解CHW和CHW主管在COMETS试验期间的经验,我们使用综合归纳和演绎主题分析方法对访谈进行了分析。结果在受访者描述保健医生角色的独特方面时,出现了三个关键主题:(1)保健医生为患者提供的向成年过渡的支持;(2)与患者建立信任关系的经验;(3)该角色对保健医生自身的影响。所有受访者都报告了chw在支持患者做好过渡准备方面做出的独特贡献,chw表示参加COMETS对他们个人和专业都有影响。结论本研究强调了CHW在CHW如何与AYA联系以及如何影响CHW方面的作用是独特的。卫生系统应探索为卫生工作者提供可持续资金和劳动力发展的途径,并投资于卫生工作者过渡规划的基础设施。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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