Using participant information to develop a tool for the evaluation of community health worker outreach services.
OBJECTIVE
Because there is no instrument that measures how clients judge community health worker (CHW) services, we sought to develop such a questionnaire. We report how we used client information to develop a brief questionnaire evaluating CHW services.


METHODS
We conducted and content-analyzed 18 in-depth semi-structured interviews of clients receiving CHW services to determine aspects of care salient to clients. Based on the results of these analyses, we developed and administered an in-person survey measuring the importance of 57 aspects of CHW services to 84 clients in 3 programs using CHWs to help control hypertension or diabetes.


RESULTS
Clients perceived a broad array of aspects of CHW care including CHW attributes, services, benefits or outcomes of service and service arrangements. The 15 aspects ranking highest included: 1) CHW knows job; 2) CHW keeps client alive; 3) CHW gives information on high blood pressure; 4) CHW shows respect; 5) blood pressure is lowered; 6) CHW pays attention; 7) client gets better medical care; 8) CHW speaks understandably; and 9) client gets needed care.


CONCLUSIONS
We used client information to generate and determine the relative importance of a pool of aspects that we and others can use to construct brief questionnaires to measure clients' judgments of CHW services. Such questionnaires are needed for ongoing evaluation as more providers and managed care organizations increase their use of CHWs for outreach programs.
Felix-Aaron
Kaytura L
KL
Agency of Healthcare Research and Quality, Rockville, MD 20852, USA. kfaaron@ahrq.gov
Bone
Lee R
LR
Levine
David M
DM
Rubin
Haya R
HR
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003153:Community Health Services / Q000592:standards*; D003150:Community Health Workers / Q000592:standards*; D003159:Community-Institutional Relations; D005069:Evaluation Studies as Topic; D005260:Female; D019538:Health Care Surveys / Q000379:methods*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D010358:Patient Participation; D017060:Patient Satisfaction; D011369:Professional-Patient Relations; D019984:Quality Indicators, Health Care; D011795:Surveys and Questionnaires / Q000592:standards*; D000078329:Workforce