9 research outputs found

    Cultural elements underlying the community health representative \u2013 client relationship on Navajo Nation

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    Abstract Background Navajo Nation Community Health Representatives (CHR) are trained community health workers (CHWs) who provide crucial services for patients and families. The success of the CHRs\u2019 interventions depends on the interactions between the CHRs and their clients. This research investigates the culturally specific factors that build and sustain the CHR-client interaction. Methods In-depth interviews were conducted with 16 CHRs on Navajo Nation. Interviews were transcribed and coded according to relevant themes. Code summaries were organized into a narrative using grounded theory techniques. Results The analysis revealed four findings critical to the development of a CHR-client relationship. Trust is essential to this relationship and provides a basis for providing quality services to the client. The ability to build and maintain trust is defined by tradition and culture. CHRs must be respectful of the diverse traditional and social practices. Lastly, the passing of clients brings together the CHR, the client\u2019s family, and the community. Conclusion Understanding the cultural elements of the CHR-client relationship will inform the work of community partners, clinical providers, and other indigenous communities working to strengthen CHR programs and obtain positive health outcomes among marginalized communities

    Additional file 1: of Cultural elements underlying the community health representative – client relationship on Navajo Nation

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    CHR Interview Guide. The interview guide was developed by the authors with the help of the Community Health Advisory Panel (CHAP). The general topics covered in the interview guide were discussed during the interviews. (DOCX 90 kb

    Providing Direct Services

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    Providing direct services centers on health-related services that are delivered in person or face-to-face and involves providing basic screening tests and basic services as well as meeting basic needs. The two authorship teams included describe ways Community Health Representatives (CHRs), Community Health Aides (CHAs), and Primary Dental Health Aides (PDHAs) are engaged in providing direct services. The lack of access to oral health care is of particular concern in Alaska, where a large proportion of the population are Alaska Native and live in the state’s 200 remote villages that are reachable only by boat, snowmobile, or bush plane. The Alaska team presents the Alaska Dental Health Aide Program (DHA program) and describes the training, work, and impact of PDHAs, who provide dental education and preventive dentistry services to their community members. The CHR team provides information on the roles, scope of work, and impacts of CHRs that primarily work in Native American communities on reservations and near reservations lands. Their stories share insight and information on the distinctive work of the culturally immersed roles of CHRs in various Southwest Tribes and Pueblos as they work to provide high-quality, culturally appropriate, clinically guided health, wellness, and social services. The diversity of tribal communities and the unique approaches CHRs take in providing services are highlighted
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