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


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)
Pages (from-to)423-436
Number of pages14
JournalQualitative Health Research
Issue number3
StatePublished - Feb 1 2020



  • 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

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