Impact of Covid-19 on Community Health Workers: Stakeholders’ Perspectives

Introduction. The COVID-19 pandemic has intensified the distress among the already overwhelmed Community Health Workers workforce. Community Health Workers (CHWs) are members of the communities they serve and work intimately with families to disseminate culturally competent resources and promote health care. Due to the COVID-19 pandemic and the CHWs’ community care position, CHWs are at a greater risk to experience levels of stress and burnout above and beyond their typical role stress. As frontline community workers, CHWs are expected to support families during times of need–this includes during a rampant pandemic. A more in-depth understanding of the impact of COVID-19 on Community Health Workers is important to help meet the needs of this essential workforce during these unprecedented times. As such, this project uses qualitative analyses to compare the perceived level of impact of COVID-19 on CHWs working in the Inland Empire (Southern California) from the perspective of the CHWs and the stakeholders (supervisor, director, academy trainer) that they work with. That is, are there differences in the perceived level of impact between the CHWs and the stakeholders? Methods. Individual semi-structured interviews were conducted with nine Community Health Workers (78% = Latin, 67% = Female) and six stakeholders (67% = Female). The first author reviewed the transcripts and used open coding to create a codebook based on common themes. Next, two graduate students used the codebook to code the transcripts’ excerpts. The ‘Impact on CHW-stress’ code was weighed on a scale from 1-5 (1 = stress is better, 3 = stayed the same, 5 = worse stress). Finally, all three met to solve inconsistencies through consensus coding. Results. Qualitative data analysis revealed both the CHWs and stakeholders reported one of the greatest impacts of COVID-19 on CHWs was stress. Seventy-eight percent of CHWs reported higher levels of stress as a direct result of COVID-19. CHWs reported increased demands to their position while coping with the unpleasant consequences of the pandemic on their personal lives. All stakeholders reported higher levels of stress as a direct result of COVID-19 on CHWs. Further data analysis using weighted averages of codes revealed higher perceived levels of stress reported by stakeholders CHWs (M = 4.73) compared to perceived levels of stress reported by CHWs (M = 3.76). Stakeholders also reported higher frequency of stress compared to reports by CHWs. Moreover, stakeholders reported the second greatest impact on CHWs were lifestyle changes. The most reported lifestyle change was their role shifting from providing resources to greater caseloads and navigating virtual visits with under resourced communities. Stakeholders also expressed that CHWs need mental and emotional support, free access to therapeutic services, and appropriate Personal Protective Equipment (PPE).Discussion. These findings inform stakeholders and local programs regarding CHWs’ current stress and burnout levels as a direct result of the COVID-19 pandemic. Recommendations for programs working with CHWs are to provide greater mental health support including possible stress and burnout interventions that will help reduce stress and improve mental well-being in this workforce.