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Client Satisfaction with Community Health Workers in HIV Care Teams

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Abstract

Community health workers (CHWs) integrated in human immunodeficiency virus (HIV) care teams undertake a variety of tasks to help patients navigate health care, develop care plans, and address social needs. Given the broad role of CHWs in HIV care, we sought to understand which client attributes are associated with various dimensions of CHW satisfaction using a sample of 204 people with HIV (PWH) from various geographic regions across the United States. Multivariable linear regressions were used to determine which client attributes were associated with complete satisfaction with CHWs using 10 validated measures. The mean age of participants was 40.6 years old (SD = 12.8) and over 70% were Black or African American. Adjusted models reveal clients who were female, have marginal health literacy, or have a substance use disorder diagnosis were more likely to not be completely satisfied across multiple dimensions (p ≤ .05). Conversely, being housed and having a mental health diagnosis were associated with being more likely to be completely satisfied (p ≤ .04). Clients’ sociodemographic characteristics and health conditions may be indicative of unique needs, leading to differing expectations of CHWs. CHW training modalities should consider the complex interplay of care needs based upon different client backgrounds and experiences among PWH. Addressing unique needs resulting from social determinants of health and that arise from conditions co-occurring with HIV, such as substance use disorders, should be incorporated into CHW service delivery.

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Availability of Data and Materials

Data are available on reasonable request to the corresponding author. Permission will be sought from the Principal Investigator prior to data release.

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Acknowledgements

We are grateful for the participants, community health workers, and project staff from each site and apart of the evaluation.

Funding

This project was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) [grant number U69HA30462 “Improving Access to Care: Using Community Health Workers to Improve Linkage and Retention in HIV Care”]. Hill Wolfe and Melissa Davoust are supported by National Institute of Drug Abuse grant T32-DA041898.

Author information

Authors and Affiliations

  1. Department of Health Law, Policy & Management, Boston University School of Public Health, 715 Albany Street, Boston, MA, 02118, USA

    Hill L. Wolfe, Melissa Davoust & Mari-Lynn Drainoni

  2. Center for Innovation in Social Work and Health, Boston University School of Social Work, Boston, MA, USA

    Allyson Baughman, Linda S. Sprague Martinez & Serena Rajabiun

  3. Macro Department, Boston University School of Social Work, Boston, MA, USA

    Linda S. Sprague Martinez

  4. Department of Public Health, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, MA, USA

    Serena Rajabiun

  5. Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, MA, USA

    Mari-Lynn Drainoni

  6. Evans Center for Implementation and Improvement Sciences, Boston University, Boston, MA, USA

    Mari-Lynn Drainoni

Authors
  1. Hill L. Wolfe
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  2. Allyson Baughman
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  3. Melissa Davoust
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  4. Linda S. Sprague Martinez
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  5. Serena Rajabiun
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  6. Mari-Lynn Drainoni
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Contributions

CRediT Author Statement: HLW: conceptualization; data curation; formal analysis; methodology; writing—original draft. AB: conceptualization; data curation; formal analysis; project administration; methodology; supervision; writing—original draft. MD: Formal analysis; methodology; writing—original draft. LSSM: project administration; supervision; writing—review & editing. SR: conceptualization; project administration; writing—review and editing. M-LD: conceptualization; funding acquisition; investigation; methodology; project administration; supervision; roles/writing—original draft.

Corresponding author

Correspondence to Hill L. Wolfe.

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Conflict of interest

Dr. Linda Sprague Martinez is an external evaluator with the Boston Public Health Commission and a youth engagement consultant for America’s Promise Alliance. There are no other disclosures or conflicts of interest.

Ethical Approval

All study protocols and procedures were approved by the Boston University Medical Center and Boston University Charles River Campus Institutional Review Boards.

Consent to Participate

All participants provided informed consent to participate in this study.

Consent for Publication

All authors approved publishing the contents of this study in the Journal of Community Health.

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Wolfe, H.L., Baughman, A., Davoust, M. et al. Client Satisfaction with Community Health Workers in HIV Care Teams. J Community Health 46, 951–959 (2021). https://doi.org/10.1007/s10900-021-00978-1

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  • DOI: https://doi.org/10.1007/s10900-021-00978-1

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