PDF(Pubmed)
Abstract：
BACKGROUND: There is a growing interest in employing community wellness worker models in Indigenous populations to address inequities in healthcare access and outcomes, concerns about shortage in health and mental health human resources, and escalating burden of chronic and complex diseases driving significant increase in health services demand and costs. A thorough review of Indigenous community wellness worker models has yet to be conducted. This rapid review sought to outline the characteristics of a community wellness worker model in Indigenous contexts across the globe, detailing factors shaping implementation challenges and success.
METHODS: A rapid review of the international peer-reviewed and grey literature of OVID Medline, Global Index Medicus, Google, and Google Scholar was conducted from January to June 2022 for Indigenous community wellness/mental health worker models and comparative models. Articles were screened and assessed for eligibility. From eligible articles, data pertaining to study design and sample; description of the program, service, or intervention; model development and implementation; terminology used to describe workers; training features; job roles; funding considerations; facilitators and barriers to success; key findings; outcomes measured; and models or frameworks utilized were extracted. Data were synthesized by descriptive and pattern coding.
RESULTS: Twenty academic and eight grey literature articles were examined. Our findings resulted in four overarching and interconnected themes: (1) worker roles and responsibilities; (2) worker training, education, and experience; (3) decolonized approaches; and (4) structural supports.
CONCLUSIONS: Community wellness worker models present a promising means to begin to address the disproportionately elevated demand for mental wellness support in Indigenous communities worldwide. This model of care acts as a critical link between Indigenous communities and mainstream health and social service providers and workers fulfill distinctive roles in delivering heightened mental wellness supports to community members by leveraging strong ties to community and knowledge of Indigenous culture. They employ innovative structural solutions to bolster their efficacy and cultivate positive outcomes for service delivery and mental wellness. Barriers to the success of community wellness worker models endure, including power imbalances, lack of role clarity, lack of recognition, mental wellness needs of workers and Indigenous communities, and more.
METHODS: A rapid review of the international peer-reviewed and grey literature of OVID Medline, Global Index Medicus, Google, and Google Scholar was conducted from January to June 2022 for Indigenous community wellness/mental health worker models and comparative models. Articles were screened and assessed for eligibility. From eligible articles, data pertaining to study design and sample; description of the program, service, or intervention; model development and implementation; terminology used to describe workers; training features; job roles; funding considerations; facilitators and barriers to success; key findings; outcomes measured; and models or frameworks utilized were extracted. Data were synthesized by descriptive and pattern coding.
RESULTS: Twenty academic and eight grey literature articles were examined. Our findings resulted in four overarching and interconnected themes: (1) worker roles and responsibilities; (2) worker training, education, and experience; (3) decolonized approaches; and (4) structural supports.
CONCLUSIONS: Community wellness worker models present a promising means to begin to address the disproportionately elevated demand for mental wellness support in Indigenous communities worldwide. This model of care acts as a critical link between Indigenous communities and mainstream health and social service providers and workers fulfill distinctive roles in delivering heightened mental wellness supports to community members by leveraging strong ties to community and knowledge of Indigenous culture. They employ innovative structural solutions to bolster their efficacy and cultivate positive outcomes for service delivery and mental wellness. Barriers to the success of community wellness worker models endure, including power imbalances, lack of role clarity, lack of recognition, mental wellness needs of workers and Indigenous communities, and more.
摘要：
背景：在土著居民中采用社区健康工作者模型来解决医疗保健获取和结果方面的不平等问题，越来越引起人们的兴趣。对卫生和心理健康人力资源短缺的担忧，慢性和复杂疾病的负担不断升级，导致卫生服务需求和成本大幅增加。尚未对土著社区健康工作者模型进行彻底审查。此快速审查旨在概述全球土著环境中社区健康工作者模型的特征，详细说明塑造实施挑战和成功的因素。
方法：对OVIDMedline的国际同行评审和灰色文献的快速回顾，全球指数Medicus，Google,GoogleScholar于2022年1月至6月为土著社区健康/精神卫生工作者模型和比较模型进行了研究。对文章进行筛选和资格评估。从符合条件的文章中，与研究设计和样本有关的数据；程序描述，服务,或干预；模型开发和实施；用于描述工人的术语；培训特征；工作角色；资金考虑；促进者和成功的障碍；关键发现；衡量的结果；提取了使用的模型或框架。通过描述性和模式编码合成数据。
结果：研究了20篇学术论文和8篇灰色文献。我们的发现导致了四个总体和相互联系的主题：(1)工人角色和责任；(2)工人培训，教育,和经验；(3)非殖民化方法；(4)结构支持。
结论：社区健康工作者模型提供了一种有希望的手段，可以开始解决全球土著社区对心理健康支持需求的不成比例的增长。这种护理模式是土著社区与主流健康和社会服务提供者之间的重要联系，工人通过利用与社区的紧密联系和对土著文化的知识，在为社区成员提供更高的心理健康支持方面发挥着独特的作用。他们采用创新的结构解决方案来增强其功效，并为服务提供和心理健康培养积极的成果。社区健康工作者模型的成功障碍，包括功率失衡,角色缺乏明确性,缺乏认可,工人和土著社区的心理健康需求，还有更多.
方法：对OVIDMedline的国际同行评审和灰色文献的快速回顾，全球指数Medicus，Google,GoogleScholar于2022年1月至6月为土著社区健康/精神卫生工作者模型和比较模型进行了研究。对文章进行筛选和资格评估。从符合条件的文章中，与研究设计和样本有关的数据；程序描述，服务,或干预；模型开发和实施；用于描述工人的术语；培训特征；工作角色；资金考虑；促进者和成功的障碍；关键发现；衡量的结果；提取了使用的模型或框架。通过描述性和模式编码合成数据。
结果：研究了20篇学术论文和8篇灰色文献。我们的发现导致了四个总体和相互联系的主题：(1)工人角色和责任；(2)工人培训，教育,和经验；(3)非殖民化方法；(4)结构支持。
结论：社区健康工作者模型提供了一种有希望的手段，可以开始解决全球土著社区对心理健康支持需求的不成比例的增长。这种护理模式是土著社区与主流健康和社会服务提供者之间的重要联系，工人通过利用与社区的紧密联系和对土著文化的知识，在为社区成员提供更高的心理健康支持方面发挥着独特的作用。他们采用创新的结构解决方案来增强其功效，并为服务提供和心理健康培养积极的成果。社区健康工作者模型的成功障碍，包括功率失衡,角色缺乏明确性,缺乏认可,工人和土著社区的心理健康需求，还有更多.
