Positionality of Community Health Workers on Health Intervention Research Teams: A Scoping Review

Abstract

Community health workers (CHWs) are increasingly involved as members of health intervention research teams. Given that CHWs are engaged in a variety of research roles, there is a need for better understanding of the ways in which CHWs are incorporated in research and the potential benefits. This scoping review synthesizes evidence regarding the kinds of health research studies involving CHWs, CHWs' roles in implementing health intervention research, their positionality on research teams, and how their involvement benefits health intervention research. The scoping review includes peer-reviewed health intervention articles published between 2008-2018 in the U.S. A search of PubMed, Embase and CINAHL identified a total of 3,129 titles and abstracts, 266 of which met the inclusion criteria and underwent full text review. A total of 130 articles were identified for a primary analysis of the research and the level of CHWs involvement, and of these 23 articles were included in a secondary analysis in which CHWs participated in 5 or more intervention research phases. The scoping review found that CHWs are involved across the spectrum of research, including developing research questions, intervention design, participant recruitment, intervention implementation, data collection, data analysis, and results dissemination. CHW positionality as research partners varied greatly across studies, and they are not uniformly integrated within all stages of research. The majority of these studies employed a community based participatory research (CBPR) approach, and CBPR studies included CHWs as research partners in more phases of research relative to non-CBPR studies. This scoping review documents specific benefits from the inclusion of CHWs as partners in health intervention research and identifies strategies to engage CHWs as research partners and to ensure that CHW contributions to research are well-documented.

“Ancestral recipes”: a mixed-methods analysis of MyPlate-based recipe dissemination for Latinos in rural communities

“…MyPlate's emphasis on fruits, vegetables, legumes, and nuts is well-suited to immigrants raised on a traditional Mesoamerican diet of maize, beans (e. g., black, pinto), and squash (e.g., pumpkin, acorn squash) [18]. Furthermore, as this study and others have found, having bilingual, bicultural community health workers (i.e., promotores de salud) as change agents, rather than masters-level health educators, is consistent with community health practices in low-income Latinx communities [19]. The use of MyPlate guidelines for behavior change practices of weight control is facilitated by the increased satiety, emotional wellbeing, and quality of life associated with consuming more minimally processed foods [20][21][22].…”

Results From La Vida Buena (The Good Life): A Quasi-Experimental Intervention of a Community Health Worker–Led Family-Based Childhood Obesity Program for Latino Children 5–8 Years of Age on the U.S.-Mexico Border

“…More broadly, a scoping review of CHWs as partners in research projects showed that CHWs contributed to the effectiveness and the sustainability of research projects in myriad ways (Coulter et al, 2020). The continued inclusion of CHWs in all aspects of childhood obesity interventions will support the development of more effective and culturally competent interventions (Coulter et al, 2020; Schroeder et al, 2018). Furthermore, interventions must be tailored to the specific cultural and local community context, and CHWs should be involved in that process to ensure that learning activities are actionable and relevant.…”

“…The inclusion of CHWs in all aspects of the intervention design and implementation supported the improvements in health behaviors. The CHWs tailored (Coulter et al, 2020). The continued inclusion of CHWs in all aspects of childhood obesity interventions will support the development of more effective and culturally competent interventions (Coulter et al, 2020;Schroeder et al, 2018).…”

La vida en la frontera: protocol for a prospective study exploring stress and health resiliencies among Mexican-origin individuals living in a US-Mexico border community

“…Throughout the development of this study, partners engaged in research-focused interactive workshops on qualitative interviewing, quantitative surveying methods, the biological stress and chronic disease linkage, and biomarker health assessments. In our experience and similar to other research efforts, CHW involvement in the research process increases their capacity to translate skills learned directly to their practice as community leaders and encourages advocacy and the enactment of sustained health promotion practices at individual and systemic levels creating a lasting community resource [ 37 ].…”