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Therapeutic Relationship and Study Adherence in a Community Health Worker-Led Intervention

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Abstract

Community health workers (CHWs) are increasingly utilized to reach low-resource communities. A critical domain influencing success is the CHWs’ ability to create and maintain a therapeutic relationship with the participants they serve. A limited evidence base exists detailing this construct, and evaluating CHW-participant relationships in the context of CHW-led programs. In a longitudinal study design, data on this therapeutic relationship were collected [as captured using The Scale to Assess the Therapeutic Relationship in Community Mental Health Care (STAR)] on 141 participants who had been assigned to a CHW during their perinatal period. Results indicate that therapeutic relationship was associated with the participant’s psychosocial health, and independently predicted study adherence in the longitudinal intervention. Changes in therapeutic relationship over the months following birth were strongly associated with changes in anxiety and depression symptoms. A trustful relationship is critical in ensuring CHWs can effectively reach the population they serve. The findings offer additional psychometric evidence of the uses and benefits of STAR outside of the traditional clinical setting in the context of public health research.

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Acknowledgments

This research was supported by the National Institutes of Health under Grant Number 5U19ES020677. The authors thank the CHWs Starleen Maharaj-Lewis, Christine Dennis, Onita Harris, Courtney Schultheis, Patricia Davis, and Kimisha Sawyer for their commitment to the study subjects and aiding in data collection. Special thanks to Farah Arosemena and Dr. Hannah Covert, for their guidance and expertise during the design and implementation of the study.

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Authors and Affiliations

  1. Department of Global Environmental Health Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA

    Christopher Mundorf, Terrance Peng, Anna Hassan & Maureen Y. Lichtveld

  2. Department of Biostatistics, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA

    Arti Shankar

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  1. Christopher Mundorf
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  2. Arti Shankar
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  3. Terrance Peng
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  4. Anna Hassan
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  5. Maureen Y. Lichtveld
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Correspondence to Christopher Mundorf.

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Mundorf, C., Shankar, A., Peng, T. et al. Therapeutic Relationship and Study Adherence in a Community Health Worker-Led Intervention. J Community Health 42, 21–29 (2017). https://doi.org/10.1007/s10900-016-0220-8

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  • DOI: https://doi.org/10.1007/s10900-016-0220-8

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