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Int J Equity Health. 2018 Feb 5;17(1):19. doi: 10.1186/s12939-018-0729-9.

Participants' perceptions of interactions with community health workers who promote behavior change: a qualitative characterization from participants with normal, depressive and anxious mood states.

Author information

1
La Clínica - Casa del Sol, 1501 Fruitvale Ave, Oakland, California, 94601, USA.
2
UT Health School of Public Health in Brownsville, Division of Health Promotion & Behavioral Sciences and Hispanic Health Research Center, One West University Blvd, Brownsville, TX, 78520, USA. Belinda.m.reininger@uth.tmc.edu.
3
Michael & Susan Dell Center for Healthy Living, UT School of Public Health, Austin Regional Campus, University of Texas Administration Building (UTA), 1616 Guadalupe Street, Suite 6.300, Austin, Texas, 78701, USA. Belinda.m.reininger@uth.tmc.edu.
4
University of Texas Health Science Center at Houston, Center for Clinical and Translational Sciences, 7000 Fannin, Suite 1800, Houston, Texas, 77030, USA. Belinda.m.reininger@uth.tmc.edu.
5
University of Texas Health Science Center at Houston, Center for Clinical and Translational Sciences, 7000 Fannin, Suite 1800, Houston, Texas, 77030, USA.
6
University of Texas Health Science Center at Houston, Biostatistics/Epidemiology/Research Design (BERD) Core, Center for Clinical and Translational Sciences, 7000 Fannin, Suite 1800, Houston, Texas, 77030, USA.
7
UT Health School of Public Health, Institute for Health Policy, Division of Management, Policy and Community Health, 6410 Fannin, Houston, TX, 77030, USA.

Abstract

BACKGROUND:

Interventions that promote healthier lifestyles among Latinos often involve community health workers (CHWs). CHWs can effectively advocate for healthier lifestyles and may be pivotal in addressing such mental health conditions as depression and anxiety. The goal of this study was to characterize the relationship dynamics between Latino participants and CHWs, from the participant's perspective. We aimed to determine if CHW-delivered community interventions effected behavior change, especially among participants who reported anxiety and depression.

METHODS:

Semi-structured interviews were conducted with a purposive sample of 28 Latino participants that was based on a mental health scoring strata. Participants completed a lifestyle intervention that included multiple home visits from CHWs to promote physical activity and healthful food choice. Interviews were conducted in the participant's preferred language (English or Spanish). Transcribed interviews were analyzed using a grounded theory approach until concept saturation was achieved.

RESULTS:

The sample was primarily female (82%), lower socioeconomic status (64%), and mean age of 50 years. Participants discussed the rapport building and professionalism of CHWs as a feature that facilitated strong, positive relationships and lifestyle behavior changes. Participants described how CHWs patterned their change approaches, which were similar to commonly used therapeutic techniques in the treatment of anxiety and depression. While anxiety and depression were described as having an impact on behavior change, most, but not all, participants who reported negative mood states said that the CHW relationship helped in changing that state to some extent.

CONCLUSIONS:

Participants' perceptions indicated that positive personal changes were influenced by CHWs. Only participants who reported consistently poor scores for depression, anxiety or both reported negative or neutral experiences with the CHWs. This study lends qualitative support to the use of CHWs as extenders of care, particularly in areas that have a shortage of primary and mental health care providers.

KEYWORDS:

Anxiety; Community health worker; Depression; Intervention; Latino; Mental health

PMID:
29402278
PMCID:
PMC5800056
DOI:
10.1186/s12939-018-0729-9
[Indexed for MEDLINE]
Free PMC Article

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