Causal Factors for Community Health Worker Effectiveness among NYC Immigrants

• In Event: 549 - Section on International Migration Refereed Roundtable Session and Business Meeting
  In Refereed Roundtable 60min: Table 09. Health

Abstract

Introduction: The negative effects of chronic diseases are rapidly increasing among immigrant populations. Community Health Workers (CHWs) have great potential to reduce health disparities associated with rising levels of chronic disease. However, current research is not fully conclusive about what factors influence CHW effectiveness.
Objectives: This study sought to examine 1) Are community health workers effective for controlling chronic disease among immigrants? 2) What are the causal factors related to CHW effectiveness 3) What are the results’ implications for improving immigrant health?
Methods: This study integrated three randomized control trials involving collaborative evaluations at New York University School of Medicine and community groups using CBPR. The programs involved diabetes and hypertension prevention and/or management for NYC Asian-American immigrants. A survey, including 30 questions about CHW effectiveness, was administered to almost 400 program participants. Univariate, bivariate, principal components and factor analyses were performed.
Results: CHW programs showed improvements in many but not all health behavior and chronic disease control health measures, with key variations in results by immigrant group and program type. A high concordance level found between CHWs and participants across demographics, especially language and culture. Analyses found six groups of factors including trust, respect and health self-efficacy as important elements of CHW effectiveness.
Conclusion:: Utilization of new measures incorporating what is unique to community health workers can help improve the health of immigrant populations. Opportunities exist to improve immigrants’ health and certain ethnic groups and chronic diseases may especially benefit from CHWs because of interpersonal factors and cultural concordance

Author

• Ephraim Shapiro