Listening to the Voices of Community Health Workers: A Multilevel, Culture-Centered Approach to Overcoming Structural Barriers in U.S. Latinx Communities

Angela L. Palmer-Wackerly, Virginia Chaidez, Caitlyn Wayment, Jonathan Baker, Anthony Adams, Lorey A. Wheeler

Research output: Contribution to journalArticle

Abstract

Community Health Workers (CHWs) are often incorporated into efforts to reduce health disparities for vulnerable populations. However, their voices are rarely the focus of research when considering how to increase their job effectiveness and sustainability. The current study addresses this gap by privileging the voices of 28 CHWs who work with Latinx communities in Nebraska through in-depth, semistructured interviews. Using a multilevel, Culture-Centered Approach (CCA) to Health Communication, we identified two key structural communication issues: (a) increasing language accommodation and (b) increasing (and stabilizing) network integration across three ecological levels of health behavior (individual, microsystem, and exosystem). This study shows the uniquely valuable perspective that CHWs have as they navigate hierarchical health care structures and community cultures to meet the needs of their Latinx clients. Findings suggest that CHWs should be included in health care organization and policy discussions to reduce health disparities for Latinx populations.

Original languageEnglish (US)
JournalQualitative Health Research
DOIs
StatePublished - Jan 1 2019

Fingerprint

Health Communication
Delivery of Health Care
Health Behavior
Health
Vulnerable Populations
Health Policy
Health Status
Language
Communication
Organizations
Interviews
Research
Population

Keywords

  • US
  • community and public health
  • community-based programs
  • cultural competence
  • culture
  • disparities
  • empowerment
  • health care
  • immigrants
  • migrants
  • minorities
  • power
  • qualitative interviews
  • refugees

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

@article{c342c9b984f241cfb1e8485adecb439e,
title = "Listening to the Voices of Community Health Workers: A Multilevel, Culture-Centered Approach to Overcoming Structural Barriers in U.S. Latinx Communities",
abstract = "Community Health Workers (CHWs) are often incorporated into efforts to reduce health disparities for vulnerable populations. However, their voices are rarely the focus of research when considering how to increase their job effectiveness and sustainability. The current study addresses this gap by privileging the voices of 28 CHWs who work with Latinx communities in Nebraska through in-depth, semistructured interviews. Using a multilevel, Culture-Centered Approach (CCA) to Health Communication, we identified two key structural communication issues: (a) increasing language accommodation and (b) increasing (and stabilizing) network integration across three ecological levels of health behavior (individual, microsystem, and exosystem). This study shows the uniquely valuable perspective that CHWs have as they navigate hierarchical health care structures and community cultures to meet the needs of their Latinx clients. Findings suggest that CHWs should be included in health care organization and policy discussions to reduce health disparities for Latinx populations.",
keywords = "US, community and public health, community-based programs, cultural competence, culture, disparities, empowerment, health care, immigrants, migrants, minorities, power, qualitative interviews, refugees",
author = "Palmer-Wackerly, {Angela L.} and Virginia Chaidez and Caitlyn Wayment and Jonathan Baker and Anthony Adams and Wheeler, {Lorey A.}",
year = "2019",
month = "1",
day = "1",
doi = "10.1177/1049732319855963",
language = "English (US)",
journal = "Qualitative Health Research",
issn = "1049-7323",
publisher = "SAGE Publications Inc.",

}

TY - JOUR

T1 - Listening to the Voices of Community Health Workers

T2 - A Multilevel, Culture-Centered Approach to Overcoming Structural Barriers in U.S. Latinx Communities

AU - Palmer-Wackerly, Angela L.

AU - Chaidez, Virginia

AU - Wayment, Caitlyn

AU - Baker, Jonathan

AU - Adams, Anthony

AU - Wheeler, Lorey A.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Community Health Workers (CHWs) are often incorporated into efforts to reduce health disparities for vulnerable populations. However, their voices are rarely the focus of research when considering how to increase their job effectiveness and sustainability. The current study addresses this gap by privileging the voices of 28 CHWs who work with Latinx communities in Nebraska through in-depth, semistructured interviews. Using a multilevel, Culture-Centered Approach (CCA) to Health Communication, we identified two key structural communication issues: (a) increasing language accommodation and (b) increasing (and stabilizing) network integration across three ecological levels of health behavior (individual, microsystem, and exosystem). This study shows the uniquely valuable perspective that CHWs have as they navigate hierarchical health care structures and community cultures to meet the needs of their Latinx clients. Findings suggest that CHWs should be included in health care organization and policy discussions to reduce health disparities for Latinx populations.

AB - Community Health Workers (CHWs) are often incorporated into efforts to reduce health disparities for vulnerable populations. However, their voices are rarely the focus of research when considering how to increase their job effectiveness and sustainability. The current study addresses this gap by privileging the voices of 28 CHWs who work with Latinx communities in Nebraska through in-depth, semistructured interviews. Using a multilevel, Culture-Centered Approach (CCA) to Health Communication, we identified two key structural communication issues: (a) increasing language accommodation and (b) increasing (and stabilizing) network integration across three ecological levels of health behavior (individual, microsystem, and exosystem). This study shows the uniquely valuable perspective that CHWs have as they navigate hierarchical health care structures and community cultures to meet the needs of their Latinx clients. Findings suggest that CHWs should be included in health care organization and policy discussions to reduce health disparities for Latinx populations.

KW - US

KW - community and public health

KW - community-based programs

KW - cultural competence

KW - culture

KW - disparities

KW - empowerment

KW - health care

KW - immigrants

KW - migrants

KW - minorities

KW - power

KW - qualitative interviews

KW - refugees

UR - http://www.scopus.com/inward/record.url?scp=85068614680&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85068614680&partnerID=8YFLogxK

U2 - 10.1177/1049732319855963

DO - 10.1177/1049732319855963

M3 - Article

C2 - 31274052

AN - SCOPUS:85068614680

JO - Qualitative Health Research

JF - Qualitative Health Research

SN - 1049-7323

ER -