Using Networks to Engage Community Health Workers in Participatory Action Research in High-Poverty Rural Communities

Abstract

Previous research shows that health and social service networks can improve service and system coordination and increase capacity to respond to critical social determinants and health needs. This article describes strategies, methods and tools used to engage community health workers (CHWs) in the development and implementation of initiatives associated with the COVID-19 Response Network, a collaborative between academicians, regional clinical and social service administrators, practitioners, and regional community and faith-based organizations. Network initiatives included community-based participatory action (CBPT) research approaches to respond to social determinants and health needs in rural Missouri during the COVID-19 pandemic. Mixed methods were used to ascertain the impact of these approaches, including surveys and key informant interviews with Network members. Survey responses showed the network to be a venue where decision-making was democratic, CHW voices were valued, and network members trusted each other. Analysis revealed two themes: How the Network improved CHWs' capacity to respond to the COVID-19 pandemic ("Getting a seat at the table") and how trust is built through relational exchange processes ("They need to believe in you"). The results clarify practical approaches to participatory action research for bringing together and maximizing the contributions of a combination of CHWs, clinicians, and administrators in clinical and social services stakeholders in the community in leadership positions to improve health outcomes. Implications for academic researchers and academic institutions are discussed.