Date of Award

January 2021

Document Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Rafael Pérez-Escamilla

Abstract

Background: Community health workers (CHWs) are becoming increasingly recognized for their contributions to community health. As the COVID-19 pandemic continues to devastate poor and underserved communities, leveraging CHWs’ experiences with vulnerable community members is key to developing an equity-centered pandemic response. This qualitative research study aimed to explore how CHWs have addressed emerging community needs and whether health and emergency management systems have fully integrated CHWs in the COVID-19 pandemic response. This study further aimed to assess, through CHWs perceptions, how well health systems have safeguarded CHWs’ health and wellbeing as they support impacted communities.

Methods: CHWs and their managers who reside in the state of Connecticut were invited to participate in this qualitative study. Semi-structured, in-depth qualitative interviews of eight CHWs and three CHW managers were performed through Zoom. CHWs and CHW managers interviewed in this study ranged from 25 to 68 years of age and represented 6 distinct Connecticut-based organizations serving demographically diverse patient populations.

Results: CHWs in this study reported undertaking new responsibilities in addition to former ones to respond to emerging community needs over the course of the COVID-19 pandemic, including (i) meeting patients’ housing, food, and mental health needs, (ii) providing COVID-19 and flu health education, (iii) connecting patients to COVID-19 and health services, and (iv) helping patients cope with experiences of racism. CHWs expressed having experienced pandemic-related strain on both their personal and professional lives and a desire but perceived inability to provide necessary resources to patients.

Conclusions: This study documented specific ways by which CHWs addressed patients’ social and health needs prior to and during the COVID-19 pandemic. Given CHWs’ ability to bridge gaps between underserved patient populations and medical and public health communities, greater investment in CHWs would likely lead to improved community health outcomes. Additionally, increased integration of CHWs into health systems and activation of CHWs in policymaking would advance health equity.

Comments

This thesis is restricted to Yale network users only. It will be made publicly available on 06/01/2022

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