BACKGROUND Community Health Representatives (CHRs) overcome health disparities in Native communities by delivering home care, health education, and community health promotion. The Navajo CHR Program partners with the non-profit Community Outreach and Patient Empowerment (COPE), to provide home-based outreach to Navajo clients living with diabetes. COPE has created an intervention (COPE intervention) focusing on multiple levels of improved care including trainings for CHRs on Motivational Interviewing and providing CHRs with culturally-appropriate education materials. The objective of this research is to understand the participant perspective of the CHR-COPE collaborative outreach through exploring patient-reported outcomes (PROs) of clients who consent to receiving the COPE intervention (COPE clients) using a qualitative methods evaluation. METHODS Seven COPE clients were selected to participate in semi-structured interviews one year after finishing COPE to explore their perspective and experiences. Qualitative interviews were recorded, transcribed, and coded to identify themes. RESULTS Clients revealed that health education delivered by CHRs facilitated lifestyle changes by helping them understand key health indicators and setting achievable goals through the use of accessible material and encouragement. Clients felt comfortable with CHRs who respected traditional practices and made regular visits. Clients also appreciated when CHRs educated their family members, who in turn were better able to support the client in their health management. Finally, CHRs who implemented the COPE intervention helped patients who were unable to regularly see a primary care doctor for critical care and support in their disease management. CONCLUSION The COPE-CHR collaboration facilitated trusting client-CHR relationships and allowed clients to better understand their diagnoses. Further investment in materials that respect traditional practices and aim to educate clients' families may foster these relationships and improve health outcomes. TRIAL REGISTRATION clinicaltrials.gov: NCT03326206. Registered 9/26/2017 (retrospectively registered).

中文翻译：

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对纳瓦霍族患者经验的社区健康代表计划的定性评估。

背景技术社区健康代表（CHR）通过提供家庭护理，健康教育和社区健康促进来克服土著社区的健康差异。Navajo CHR计划与非营利性社区外展和患者授权（COPE）合作，为患有糖尿病的Navajo客户提供家庭外展服务。COPE创建了一项干预措施（COPE干预），重点放在改善护理的多个层面上，包括对CHR进行动机访谈培训，并为CHR提供与文化相适应的教育材料。这项研究的目的是通过定性方法评估探索同意接受COPE干预的客户（COPE客户）的患者报告结果（PRO），从而了解CHR-COPE协作外展的参与者观点。方法在完成COPE一年后，选择7名COPE客户参加半结构化访谈，以探讨他们的观点和经验。记录，转录和编码定性访谈以识别主题。结果客户透露，通过使用可访问的资料和鼓励，CHR的健康教育帮助他们了解关键的健康指标并设定可实现的目标，从而促进了生活方式的改变。客户对尊重传统做法并定期拜访的CHR感到满意。当CHR培训他们的家庭成员时，客户也很感激，他们反过来可以更好地支持客户的健康管理。最后，实施COPE干预的心力衰竭患者可以帮助无法定期就诊的重症监护和支持疾病的常规护理医生。结论COPE-CHR合作促进了信任客户-CHR关系，并使客户更好地了解他们的诊断。在尊重传统做法并旨在教育客户家庭的材料上进一步投资，可以促进这种关系并改善健康状况。试验注册临床试验.gov：NCT03326206。已于2017年9月26日注册（追溯注册）。在尊重传统做法并旨在教育客户家庭的材料上进一步投资，可以促进这种关系并改善健康状况。试验注册临床试验.gov：NCT03326206。已于2017年9月26日注册（追溯注册）。在尊重传统做法并旨在教育客户家庭的材料上进一步投资，可以促进这种关系并改善健康状况。试验注册临床试验.gov：NCT03326206。已于2017年9月26日注册（追溯注册）。