Community health worker model: its implementation and importance in reaching refugee populations in the U.S.

Abstract

Purpose – The community health workers (CHWs) model, which refers to individuals from the same community, sharing the same culture and origin, was used to conduct lifestyle, food and health assessments in the refugee and immigrant communities in the study area. In order to understand the process and effectiveness of CHW model, the purpose of this paper is to identify key characteristics of CHWs; and, describe the major roles CHWs play in reaching and carrying out health-based research among under-served refugee populations. Design/methodology/approach – The results of this paper reflect a grounded theory approach that specifically analyzed core categories or themes of the CHW model that were observed and recorded from the process of a larger study examining health and diet habits of refugees. In this study, women from the study community were recruited to be trained as CHWs. Recruitment criteria for potential CHWs included women from the same origin of the study community, live in the study area for several years and have familiarity with the community, and possess basic English reading and writing skills. Findings – The results showed that CHWs were most effective when they possessed specific key characteristics. These characteristics included being invested in the community and research project, being objective and non-judgmental and able to understand guidelines of research ethics. The CHW helped to carry out the study by acting as a gatekeeper by building trust among community members and, by acting as a cultural broker by explaining the study questions using culturally appropriate probes. Research limitations/implications – The CHWs described in this study represent the key characteristics of effectiveness they possess in reaching refugee and immigrant groups in the USA. The limitation reflects the need for further examination of the characteristics that make for effective CHWs in a US-based refugee resettlement context concerning health-based research and outreach reaching a general low-income, racial/ethnic minority groups in the USA. Practical implications – The CHW model is key in conducting culturally appropriate research with an under-served and difficult to reach population. Originality/value – There is limited published research on the use of the CHW in health-based research in the USA resettlement context and this research study is one step toward closing the gap in our examination of the CHW model.