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Dissertation/Thesis Abstract

Shifting Tasks in a Broken Health Care System: Assessing the Perceptions, Attitudes and Beliefs of Community Health Workers
by Frazier, Lafarah S., D.P.H., Capella University, 2019, 140; 22624488
Abstract (Summary)

The drive behind this study was to explore the perceptions of community health workers (CHWs) who provide care to patients in mental health through task shifting. Used mainly in the developing world, task shifting is an alternative approach to combat health worker shortage and keep up with the demand for health services by increasing the responsibilities of lesser credentialed workers and reducing the responsibilities of higher credentialed workers who share tasks between patients. While task shifting has been used informally for years, many health systems today have implemented CHWs to expand access to care. CHWs have been instrumental in increasing access and providing culturally appropriate care to vulnerable populations in chronic disease management, child and maternal health, as well as behavioral health. Approximately 45 million Americans have experienced a mental illness however; more than half do not receive treatment due to issues of access. African Americans and Hispanics experience mental illness at a rate of 20% more than non-ethnic groups and only use mental health services at half the rate of Whites. As the mental health gap widens, CHWs are being used to scale up mental health services. The goal of this quantitative study was to examine the attitudes and perspectives of CHWs on task shifting in mental health. Variables such as age, race, gender and educational attainment were measured to see if attitudes towards task shifting in mental health were affected. 90 CHWs participated in this web-based research and responded to the Task Shifting Survey Questionnaire for CMHOs (Community Mental Health Workers), CPOs (Clinical Psychiatry Officers) and CMHNs (Community Mental Health Nurses). Because CHWs often share similar culture and language to the population they serve, cultural competence was used as a theoretical framework. Results indicated that while many of the CHWs were familiar with task shifting and admittedly performed duties outside of their scope, their opinions on task shifting were not affected by race or culture. The results showed that education was negatively correlated with attitude towards task shifting. Conclusions were inconsistent with the available literature on CHWs and culture. This research not examine the effectiveness of CHWs in mental health interventions and further research is needed to examine the use of CHWs in mental health in the US. Additionally, future research should be conducted replicating the study and possibly using cultural responsiveness as a framework and alternative to cultural competence.

Indexing (document details)
Advisor: Benton, Stacy
Commitee: Raphael, Monae, Gambone, James
School: Capella University
Department: School of Nursing and Health Sciences
School Location: United States -- Minnesota
Source: DAI-B 81/4(E), Dissertation Abstracts International
Subjects: Mental health, Public health
Keywords: Community Health Worker, Cultural Competence, Lay Worker, Mental Illness, Non Specialist Health Worker, Task Shifting
Publication Number: 22624488
ISBN: 9781687991546
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