Evidence map›Paper›PMID 32546585›Full record

ArticleBMJ global health2020

The community health worker as service extender, cultural broker and social change agent: a critical interpretive synthesis of roles, intent and accountability.

Marta Schaaf, Caitlin Warthin, Lynn Freedman, Stephanie M Topp

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ global health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05211869 (T1DTechCHW), which is not on this map. Cited by 70 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
70citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05211869 nacompletednot on this mapstarted 2022, after this paper: background citation

T1DTechCHW: Enhancing the Community Health Worker (CHW) Model to Promote Diabetes Technology Use in Young Adults From Underrepresented Minority Groups (YA-URMs) With Type 1 Diabetes (T1D)

TypeinterventionalSponsorAlbert Einstein College of MedicineRan2022 to 2025Enrolled119ConditionsDiabetes, Type 1 Diabetes, Young Adult, Diabetes MellitusArmsT1D-CATCH
3 · Its place in the literature

Who cites it

70 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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10 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Marta SchaafIndependent Consultant, Brooklyn, New York, USA martaschaafconsult@gmail.com.ORCID 0000-0002-7616-5966
Caitlin WarthinAverting Maternal Death and Disability, Heilbrunn Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, New York, USA.
Lynn FreedmanAverting Maternal Death and Disability, Heilbrunn Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, New York, USA.
Stephanie M ToppCollege of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia.ORCID 0000-0002-3448-7983

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

This paper is a critical interpretive synthesis of community health workers (CHWs) and accountability in low-income and middle-income countries. The guiding questions were: What factors promote or undermine CHWs as accountability agents? (and) Can these factors be intentionally fostered or suppressed to impel health system accountability? We conducted an iterative search that included articles addressing the core issue of CHWs and accountability, and articles addressing ancillary issues that emerged in the initial search, such as 'CHWs and equity.'CHWs are intended to comprise a 'bridge' between community members and the formal health system. This bridge function is described in three key ways: service extender, cultural broker, social change agent. We identified several factors that shape the bridging function CHWs play, and thus, their role in fomenting health system accountability to communities, including the local political context, extent and nature of CHW interactions with other community-based structures, health system treatment of CHWs, community perceptions of CHWs, and extent and type of CHW unionisation and collectivisation.Synthesising these findings, we elaborated several analytic propositions relating to the self-reinforcing nature of the factors shaping CHWs' bridging function; the roles of local and national governance; and the human resource and material capacity of the health system. Importantly, community embeddedness, as defined by acceptability, social connections and expertise, is a crucial attribute of CHW ability to foment local government accountability to communities.

Indexed as

Community Health WorkersSocial ChangeGovernment ProgramsHumansQualitative ResearchSocial Responsibilityhealth systemsreview

Identifiers

PMID32546585
PMCPMC7299037

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.