Mechanisms for Community Health Worker Action on Patient-, Institutional-, and Community-Level Barriers to Primary Care in a Safety-Net Setting

Authors: Savanna L Carson, Clemens Hong, Heidi Behforouz, Emily Chang, Lydia Z Dixon, Diane Factor, Sheba M George, Jenebah Lewis, Angelina Majeno, Maria Morales, Courtney Porter, Ami Shah, Stefanie D Vassar, Arleen F Brown

This study sought to determine how barriers emerging at various levels impact CHWs in primary care settings. Researchers conducted focus groups with 25 patients and 17 CHWs. Participants reported that CHWs addressed patient-level barriers through social support and empowerment. Additionally, participants stated that CHWs used communication, advocacy for fair treatment, and enhanced awareness of patient circumstances to address system-level barriers. Overall, this study may inform future practice for CHWs facing a number of common restraints in primary care settings.