Expanding Care-Delivery: A SWOT Analysis of the Community Health Aide Program in Three Oklahoma Tribes

Area of Science:

• Public Health
• Healthcare Systems Research
• Indigenous Health

Background:

• American Indians and Alaska Natives face significant health disparities, including lower life expectancies and poorer oral health.
• Barriers such as provider shortages and limited access to services hinder routine care for these populations.
• The Community Health Aide Program (CHAP) utilizes certified mid-level providers to enhance healthcare access.

Purpose of the Study:

• To evaluate the benefits and challenges of integrating the CHAP model within existing Tribal health systems.
• To assess the potential of CHAP expansion for improving medical, behavioral, and dental healthcare access.
• To identify specific strengths, weaknesses, opportunities, and threats associated with CHAP integration.

Main Methods:

• Qualitative analysis of de-identified data from CHAP expansion efforts in three Tribal Nations in Oklahoma.
• Utilized a SWOT (Strengths, Weaknesses, Opportunities, Threats) analysis framework for thematic development.
• Focused on themes affecting Tribal healthcare systems, with a specific emphasis on dental healthcare.

Main Results:

• A total of 272 themes were identified: 99 strengths, 52 weaknesses, 69 opportunities, and 52 threats.
• Key subthemes included Interprofessional/Community Connections, Technology/Infrastructure, Workforce Staffing, Administrative Coordination/Funding, and Cultural Responsiveness.
• In dental healthcare specifically, 59 themes were identified, with 20 strengths and 21 opportunities.

Conclusions:

• The Community Health Aide Program (CHAP) is a historically successful model for delivering care to underserved populations.
• Integration and expansion of CHAP present more identified strengths and opportunities than weaknesses and threats.
• CHAP holds significant potential for improving access to comprehensive medical, behavioral, and dental healthcare for Tribal communities.