Evaluating a community-placed and clinically integrated community health worker program: A realist approach

Jane W. Njeru, Jennifer L. Ridgeway, Gladys B. Asiedu, Carmen Radecki Breitkopf, Jean M. Gunderson, Onelis Quirindongo-Cedenõ, Michael W. O'Brien, Tara M. Nelson, Ron Buzard, Mark L. Wieland

Research output: Contribution to journalArticle

Abstract

Community health worker (CHW) programs can act as bridges between patients and health care teams, but the complexity and variability of program components and outcomes make them difficult to evaluate. This evaluation used a realist approach to identify underlying mechanisms and contextual factors associated with successful implementation of a community-placed CHW program affiliated with a primary care practice in the Midwest United States. The analysis identified mechanisms by which stakeholders built trust, self-efficacy, and empowerment to improve patient-centered outcomes and experiences. It also identified conditions that support activation of these mechanisms, including the ability of CHWs to make home visits, effective communication between members of the care team across settings, and clarity about the role of the CHW relative to other support services for patients. This type of context-mechanism-outcome evaluation facilitated development of recommendations responsive to local context.

Original languageEnglish (US)
Pages (from-to)116-127
Number of pages12
JournalJournal of Ambulatory Care Management
Volume42
Issue number2
DOIs
StatePublished - Apr 1 2019

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Keywords

  • community-based interventions
  • patient-centered care
  • program evaluation
  • qualitative research
  • realist evaluation

ASJC Scopus subject areas

  • Health Policy

Cite this

Njeru, J. W., Ridgeway, J. L., Asiedu, G. B., Radecki Breitkopf, C., Gunderson, J. M., Quirindongo-Cedenõ, O., O'Brien, M. W., Nelson, T. M., Buzard, R., & Wieland, M. L. (2019). Evaluating a community-placed and clinically integrated community health worker program: A realist approach. Journal of Ambulatory Care Management, 42(2), 116-127. https://doi.org/10.1097/JAC.0000000000000268