Abstract
BackgroundNavajo Nation Community Health Representatives (CHR) are trained community health workers (CHWs) who provide crucial services for patients and families. The success of the CHRs’ interventions depends on the interactions between the CHRs and their clients. This research investigates the culturally specific factors that build and sustain the CHR-client interaction.MethodsIn-depth interviews were conducted with 16 CHRs on Navajo Nation. Interviews were transcribed and coded according to relevant themes. Code summaries were organized into a narrative using grounded theory techniques.ResultsThe analysis revealed four findings critical to the development of a CHR-client relationship. Trust is essential to this relationship and provides a basis for providing quality services to the client. The ability to build and maintain trust is defined by tradition and culture. CHRs must be respectful of the diverse traditional and social practices. Lastly, the passing of clients brings together the CHR, the client’s family, and the community.ConclusionUnderstanding the cultural elements of the CHR-client relationship will inform the work of community partners, clinical providers, and other indigenous communities working to strengthen CHR programs and obtain positive health outcomes among marginalized communities.
Highlights
Navajo Nation Community Health Representatives (CHR) are trained community health workers (CHWs) who provide crucial services for patients and families
The Navajo Nation Department of Health (NNDOH) oversees the Navajo Nation Community Health Representative & Outreach Program that employs community health workers known as Community Health Representatives (CHRs) [12]
Trust plays a vital role in the CHR-client relationship we discuss several reasons why trust is important for clients
Summary
Navajo Nation Community Health Representatives (CHR) are trained community health workers (CHWs) who provide crucial services for patients and families. Community health workers (CHWs) are trained community members who provide medical services to their clients (on Navajo Nation, the term “client” is used to refer to the beneficiary of the services of the CHW) [1, 2]. The objective of our research is to investigate and understand the cultural factors that impact the CHWclient relationship, focusing on the Navajo cultural context These cultural factors are investigated through one-on-one qualitative interviews with CHWs. Gampa et al BMC Health Services Research (2017) 17:19 as a case study to understand the importance of culture and the role culture plays in improving health outcomes. For the purpose of this paper, the term “CHR” will be used to describe Community Health Representatives on Navajo and “CHW” will refer to community health workers or similar roles elsewhere
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