A qualitative analysis of clinician perspectives on community health worker integration at epilepsy centers

Substantial evidence supports community health worker (CHW) interventions lead to improved health outcomes, but health professionals' perceptions of CHW roles and effectiveness may slow integration into care delivery systems. Research on CHWs as members of specialty care teams in clinical settings, especially in the epilepsy field, is limited.

We conducted semi-structured interviews between April and October 2022 to explore perceptions of multidisciplinary clinicians (n = 12; physicians, nurses, social workers) based at five New England epilepsy centers about the potential for successful CHW integration on specialist epilepsy center care teams. Transcripts were analyzed using a mixed inductive and deductive thematic approach.

Themes that emerged included: (1) limited epilepsy clinician awareness of the CHW role and minimal experience working with a CHW; (2) limited clinician knowledge of how to recruit CHWs; (3) preference for CHW roles and responsibilities in epilepsy centers being focused on social determinants of health (4) clinician uncertainty around scope of CHW training and supervision; (5) unknown funding mechanisms for CHW integration in epilepsy centers; (6) knowledge of care gaps in addressing social determinants of health needs by epilepsy centers; (7) openness by epilepsy center care team members to CHW integration; and (8) environment and collaborative culture at epilepsy centers.

Despite limited knowledge and experience regarding CHW roles and mechanisms for recruiting and sustaining CHW positions, the multidisciplinary clinicians interviewed valued the potential benefits of CHWs in an epilepsy center and endorsed a need to better address patients' unmet social determinants of health needs.