Journal of Community Health

, Volume 44, Issue 1, pp 159–168 | Cite as

Patient and Community Health Worker Perceptions of Community Health Worker Clinical Integration

  • Charlotte M. LewisEmail author
  • Thelma Gamboa-Maldonado
  • Juan Carlos Belliard
  • Anna Nelson
  • Susanne Montgomery
Original Paper


Traditional community health workers (CHWs) are expanding their role into clinical settings (cCHW) to support patients with care coordination and advocacy services. We investigated the potential to integrate cCHWs, via evaluation of patients’ and CHWs’ key demographics, needs, and abilities. This mixed-methods study, including adult patients and CHWs, was conducted in the Inland Valley of Southern California, between 2016 and 2017. Survey data, key informant interviews, and focus group discussions were evaluated to compare patient/CHW core demographics, and contrast patient-identified healthcare needs against CHW-identified cCHW service capabilities. Quantitative data were evaluated descriptively and bi-variably using two-sample independent t tests and Pearson’s Chi square tests. Qualitative data were coded for emerging themes using a priori and standard grounded theory methods. Patients and CHWs were significantly similar in age, education, and income, but significantly differed in gender, race, United States generation, and marital status. For all healthcare-related services in which patients and CHWs exhibited significant differences, the odds CHWs perceived themselves capable of performing services were greater than patients’ stated need of services. Patients and CHWs overlapped regarding their expectations of cCHWs. Although patients and CHWs differed somewhat, they shared many of the same expectations for cCHW integration. This information is critical to further contextualize cCHW training programs and emphasizes the need to education patients about this exciting new form of healthcare delivery. The active role of cCHWs in the clinical care team and the community may expand patient access to preventive healthcare, improve care quality, and minimize health inequities.


Clinical community health worker Patient Perceptions Clinical integration 


Author Contributions

Support for data collection and validation in this article was provided by Marisol Lara, Sarah Snyder, and Jonathan Carrillo, graduate students in the Loma Linda University School of Public Health, and Lily Lee, Director of Academic Programs at the Promotores Academy. Support for data translation and validation was provided by Erika Marroquin and Vilma Lopez, Community Health Workers associated with the Promotores Academy, and Victoria Belliard, a student volunteer associated with Loma Linda University. Support for data analysis was provided by Walshe Izumigawa, a research analyst at Loma Linda University Research Consulting Group.


Research reported in this publication was supported by the National Institute of Minority Health and Health Disparities of the National Institutes of Health under award number P20MD006988. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest. No financial disclosures were reported by the authors of this paper. The data collection and analyses processes were approved by the Loma Linda University Institutional Review Board (project identification number: 5160301).


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.School of Public HealthLoma Linda UniversityLoma LindaUSA
  2. 2.Global Health, School of Public HealthLoma Linda UniversityLoma LindaUSA
  3. 3.Health Promotion and Education, School of Public HealthLoma Linda UniversityLoma LindaUSA
  4. 4.School of Behavioral HealthLoma Linda UniversityLoma LindaUSA

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