“I promised them I would be there”: A qualitative study of the changing roles of cultural health navigators who serve refugees during the COVID-19 pandemic

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dc.contributor.authorSchuster, Roseanne C.
dc.contributor.authorWachter, Karin
dc.contributor.authorMcRae, Kenna
dc.contributor.authorMcDaniel, Anne
dc.contributor.authorDavis, Olga I.
dc.contributor.authorNizigiyimana, Jeanne
dc.contributor.authorJohnson-Agbakwu, Crista E
dc.contributor.departmentObstetrics and Gynecologyen_US
dc.contributor.departmentPopulation and Quantitative Health Sciencesen_US
dc.date.accessioned2024-07-19T16:18:13Z
dc.date.available2024-07-19T16:18:13Z
dc.date.issued2024-07-13
dc.description.abstractCultural health navigators (CHNs) are one type of community health worker (CHW), a front-line cadre critical to mitigating the COVID-19 pandemic among marginalized communities. Yet little is documented about the roles of CHNs serving resettled refugees both before and during the pandemic. The objective of this study was to examine shifts in how CHNs carried out their work with refugee patients at a particular time point in the COVID-19 pandemic. In August 2020, we conducted virtual and serial semi-structured interviews with ten CHNs at a U.S. healthcare system serving ethnically and linguistically diverse refugee communities. We used a thematic analysis approach to code and interpret data. The analysis indicated that CHNs’ descriptions of their work with refugee clients and communities largely mapped onto established CHW roles: cultural mediation, care coordination, system navigation, education, and outreach and social support; however, how CHNs fulfilled their roles shifted dramatically during the pandemic. CHNs were unable to physically navigate patients through the system due to safety measures and telemedicine and deeply felt the loss of providing in-person outreach and social support. To offset constraints, CHNs increased the number and scope of virtual contacts with patients and launched novel education, outreach, and social support strategies. Through their adapted strategies, CHNs nurtured a strong foundation of trust to provide continuous care under challenging circumstances, although they were concerned that the lack of in-person interactions decreased patients' sensitive disclosures. The analysis illuminates the important and often unrecognized work of CHWs and informs ongoing efforts to prioritize community health work in U.S. healthcare policy and practice.en_US
dc.identifier.citationSchuster RC, Wachter K, McRae K, McDaniel A, Davis OI, Nizigiyimana J, Johnson-Agbakwu CE. “I promised them I would be there”: A qualitative study of the changing roles of cultural health navigators who serve refugees during the COVID-19 pandemic. Social Sciences & Humanities Open. 2024 Jan 1;10:101002. doi: https://doi.org/10.1016/j.ssaho.2024.101002.en_US
dc.identifier.doi10.1016/j.ssaho.2024.101002en_US
dc.identifier.issn2590-2911
dc.identifier.piiS2590291124001992
dc.identifier.urihttps://hdl.handle.net/20.500.14038/53645
dc.language.isoen
dc.publisherElsevier BVen_US
dc.relation.ispartofSocial Sciences & Humanities Openen_US
dc.relation.urlhttps://doi.org/10.1016/j.ssaho.2024.101002en_US
dc.rights© 2024 The Authors. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/bync-nd/4.0/).en_US
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 International*
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/*
dc.source.beginpage101002
dc.source.journaltitleSocial Sciences & Humanities Open
dc.source.volume10
dc.subjectcommunity health worker (CHW)en_US
dc.subjectCore Consensus (C3 Project)en_US
dc.subjectrefugeeen_US
dc.subjectpatient navigationen_US
dc.subjectculturally-centered healthcareen_US
dc.subjectoutreachen_US
dc.subjectCOVID-19 pandemicen_US
dc.title“I promised them I would be there”: A qualitative study of the changing roles of cultural health navigators who serve refugees during the COVID-19 pandemicen_US
dc.typeJournal Articleen_US
dspace.entity.typePublication
refterms.dateFOA2024-07-19T16:18:15Z
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