IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v19y2022i5p2496-d755218.html
   My bibliography  Save this article

Understanding Trustful Relationships between Community Health Workers and Vulnerable Citizens during the COVID-19 Pandemic: A Realist Evaluation

Author

Listed:
  • Dorien Vanden Bossche

    (Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium)

  • Sara Willems

    (Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium)

  • Peter Decat

    (Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium)

Abstract

(1) Background: Community health workers (CHWs) are an essential public health workforce defined by their trustful relationships with vulnerable citizens. However, how trustful relationships are built remains unclear. This study aimed to understand how and under which circumstances CHWs are likely to build trust with their vulnerable clients during the COVID-19 pandemic. (2) Methods: We developed a program theory using a realist research design. Data were collected through focus groups and in-depth interviews with CHWs and their clients. Using a grounded theory approach, we aimed to unravel mechanisms and contextual factors that determine the trust in a CHW program offering psychosocial support to vulnerable citizens during the COVID-19 pandemic. (3) Results: The trustful relationship between CHWs and their clients is rooted in three mental models: recognition, equality, and reciprocity. Five contextual factors (adopting a client-centered attitude, coordination, temporariness, and link with primary care practice (PCP)) enable the program mechanisms to work. (4) Conclusions: CHWs are a crucial public health outreach strategy for PCP and complement and enhance trust-building by primary care professionals. In the process of building trustful relationships between CHWs and clients, different mechanisms and contextual factors play a role in the trustful relationship between primary care professionals and patients. Future research should assess whether these findings also apply to a non-covid context, to the involvement of CHWs in other facets of primary healthcare (e.g., prevention campaigns, etc.), and to a low- and middle-income country (LMIC) setting. Furthermore, implementation research should elaborate on the integration of CHWs in PCP to support CHWs in developing the mental models leading to build trust with vulnerable citizens and to establish the required conditions.

Suggested Citation

  • Dorien Vanden Bossche & Sara Willems & Peter Decat, 2022. "Understanding Trustful Relationships between Community Health Workers and Vulnerable Citizens during the COVID-19 Pandemic: A Realist Evaluation," IJERPH, MDPI, vol. 19(5), pages 1-15, February.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:5:p:2496-:d:755218
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/19/5/2496/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/19/5/2496/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. repec:aph:ajpbhl:10.2105/ajph.2017.303985_5 is not listed on IDEAS
    2. Dorien Vanden Bossche & Susan Lagaert & Sara Willems & Peter Decat, 2021. "Community Health Workers as a Strategy to Tackle Psychosocial Suffering Due to Physical Distancing: A Randomized Controlled Trial," IJERPH, MDPI, vol. 18(6), pages 1-15, March.
    3. Morgan, A.U. & Grande, D.T. & Carter, T. & Long, J.A. & Kangovi, S., 2016. "Penn Center for community health workers: Step-by-step approach to sustain an evidence-based community health worker intervention at an academic medical center," American Journal of Public Health, American Public Health Association, vol. 106(11), pages 1958-1960.
    4. Norma C Ware & John Idoko & Sylvia Kaaya & Irene Andia Biraro & Monique A Wyatt & Oche Agbaji & Guerino Chalamilla & David R Bangsberg, 2009. "Explaining Adherence Success in Sub-Saharan Africa: An Ethnographic Study," PLOS Medicine, Public Library of Science, vol. 6(1), pages 1-7, January.
    5. Benjamin Saunders & Julius Sim & Tom Kingstone & Shula Baker & Jackie Waterfield & Bernadette Bartlam & Heather Burroughs & Clare Jinks, 2018. "Saturation in qualitative research: exploring its conceptualization and operationalization," Quality & Quantity: International Journal of Methodology, Springer, vol. 52(4), pages 1893-1907, July.
    6. Gilson, Lucy, 2003. "Trust and the development of health care as a social institution," Social Science & Medicine, Elsevier, vol. 56(7), pages 1453-1468, April.
    7. Thiede, Michael, 2005. "Information and access to health care: is there a role for trust?," Social Science & Medicine, Elsevier, vol. 61(7), pages 1452-1462, October.
    8. Kangovi, S. & Mitra, N. & Grande, D. & Huo, H. & Smith, R.A. & Long, J.A., 2017. "Community health worker support for disadvantaged patients with multiple chronic diseases: A randomized clinical trial," American Journal of Public Health, American Public Health Association, vol. 107(10), pages 1660-1667.
    9. Jens Detollenaere & Lise Hanssens & Veerle Vyncke & Jan De Maeseneer & Sara Willems, 2017. "Do We Reap What We Sow? Exploring the Association between the Strength of European Primary Healthcare Systems and Inequity in Unmet Need," PLOS ONE, Public Library of Science, vol. 12(1), pages 1-13, January.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Ezumah, Nkoli & Manzano, Ana & Ezenwaka, Uchenna & Obi, Uche & Ensor, Tim & Etiaba, Enyi & Onwujekwe, Obinna & Ebenso, Bassey & Uzochukwu, Benjamin & Huss, Reinhard & Mirzoev, Tolib, 2022. "Role of trust in sustaining provision and uptake of maternal and child healthcare: Evidence from a national programme in Nigeria," Social Science & Medicine, Elsevier, vol. 293(C).
    2. Athias, Laure & Macina, Moudo, 2022. "Demand for vaccination in Sub-Saharan Africa: The vertical legacy of the slave trade," Social Science & Medicine, Elsevier, vol. 293(C).
    3. Katarzyna Krot & Iga Rudawska, 2021. "How Public Trust in Health Care Can Shape Patient Overconsumption in Health Systems? The Missing Links," IJERPH, MDPI, vol. 18(8), pages 1-15, April.
    4. Kruk, Margaret E. & Freedman, Lynn P. & Anglin, Grace A. & Waldman, Ronald J., 2010. "Rebuilding health systems to improve health and promote statebuilding in post-conflict countries: A theoretical framework and research agenda," Social Science & Medicine, Elsevier, vol. 70(1), pages 89-97, January.
    5. Mohseni, Mohabbat & Lindstrom, Martin, 2007. "Social capital, trust in the health-care system and self-rated health: The role of access to health care in a population-based study," Social Science & Medicine, Elsevier, vol. 64(7), pages 1373-1383, April.
    6. Teela, Katherine C. & Mullany, Luke C. & Lee, Catherine I. & Poh, Eh & Paw, Palae & Masenior, Nicole & Maung, Cynthia & Beyrer, Chris & Lee, Thomas J., 2009. "Community-based delivery of maternal care in conflict-affected areas of eastern Burma: Perspectives from lay maternal health workers," Social Science & Medicine, Elsevier, vol. 68(7), pages 1332-1340, April.
    7. Jennifer Tartaglia & Michelle McIntosh & Jonine Jancey & Jane Scott & Andrea Begley, 2021. "Exploring Feeding Practices and Food Literacy in Parents with Young Children from Disadvantaged Areas," IJERPH, MDPI, vol. 18(4), pages 1-18, February.
    8. Najwa Taghy & Linda Cambon & Caroline Boulliat & Olivier Aromatario & Claude Dussart, 2021. "Exploring the Determinants of Polypharmacy Prescribing and Dispensing Behaviours in Primary Care for the Elderly—Protocol for a Qualitative Study," IJERPH, MDPI, vol. 18(14), pages 1-10, July.
    9. Van Droogenbroeck, Ellen & Van Hove, Leo, 2020. "Intra-household task allocation in online grocery shopping: Together alone," Journal of Retailing and Consumer Services, Elsevier, vol. 56(C).
    10. Thuy Séran & Anne-Sophie Fernandez & Hervé Chappert, 2024. "Managing coopetition in multi-unit organizations: a management-control perspective," Review of Managerial Science, Springer, vol. 18(10), pages 2889-2924, October.
    11. Şahika Simsek-Cetinkaya & Simge Evrenol Ocal, 2023. "“Psychological Injuries Are Not Visible†: Experiences and Perceptions of Midwives and Nurses about Domestic Violence during Pregnancy," Clinical Nursing Research, , vol. 32(8), pages 1115-1123, November.
    12. Young Suk Yoon & Boyoung Jung & Dongsu Kim & In-Hyuk Ha, 2019. "Factors Underlying Unmet Medical Needs: A Cross-Sectional Study," IJERPH, MDPI, vol. 16(13), pages 1-19, July.
    13. Najwa Taghy & Viviane Ramel & Ana Rivadeneyra & Florence Carrouel & Linda Cambon & Claude Dussart, 2023. "Exploring the Determinants of Polypharmacy Prescribing and Dispensing Behaviors in Primary Care for the Elderly—Qualitative Study," IJERPH, MDPI, vol. 20(2), pages 1-17, January.
    14. Xudan Lin & Hong Zhu & Duo Yin, 2022. "Enhancing Rural Resilience in a Tea Town of China: Exploring Tea Farmers’ Knowledge Production for Tea Planting, Tea Processing and Tea Tasting," Land, MDPI, vol. 11(4), pages 1-18, April.
    15. Silvia Scaramuzzi & Sara Gabellini & Giovanni Belletti & Andrea Marescotti, 2021. "Agrobiodiversity-Oriented Food Systems between Public Policies and Private Action: A Socio-Ecological Model for Sustainable Territorial Development," Sustainability, MDPI, vol. 13(21), pages 1-32, November.
    16. Asiimire Donath & Medard Twinamatsiko & Johnson Atwiine & Dr. Nuwatuhaire Benard, 2024. "Women Productive Resource Ownership and their Contribution to the Changing Family Patterns in Ankole Sub-Region, Uganda," International Journal of Research and Scientific Innovation, International Journal of Research and Scientific Innovation (IJRSI), vol. 11(5), pages 844-855, May.
    17. Tongyu Meng & Jamie Newth & Christine Woods, 2022. "Ethical Sensemaking in Impact Investing: Reasons and Motives in the Chinese Renewable Energy Sector," Journal of Business Ethics, Springer, vol. 179(4), pages 1091-1117, September.
    18. Schneider, Pia, 2005. "Trust in micro-health insurance: an exploratory study in Rwanda," Social Science & Medicine, Elsevier, vol. 61(7), pages 1430-1438, October.
    19. Annette Peart & Virginia Lewis & Chris Barton & Grant Russell, 2020. "Healthcare professionals providing care coordination to people living with multimorbidity: An interpretative phenomenological analysis," Journal of Clinical Nursing, John Wiley & Sons, vol. 29(13-14), pages 2317-2328, July.
    20. Jyh-Jeng Wu & Yueh-Mei Chen & Paul C. Talley & Kuang-Ming Kuo, 2021. "Does Online Community Participation Contribute to Medication Adherence? An Empirical Study of Patients with Chronic Diseases," IJERPH, MDPI, vol. 18(10), pages 1-16, May.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:19:y:2022:i:5:p:2496-:d:755218. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.