AUTHOR=Job Nophiwe , Johnston Jamie Sewan , Westgate Carey , Skinner Nadine Ann , Ward Victoria , Ballard Madeleine ,  CHW Advisory Group 

TITLE=Community health worker perspectives on advocacy: design-based research to develop a digital advocacy training course

JOURNAL=Frontiers in Public Health

VOLUME=12

YEAR=2024

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2024.1334279

DOI=10.3389/fpubh.2024.1334279

ISSN=2296-2565

ABSTRACT=<sec id="sec1"><title>Introduction</title><p>While community health workers (CHWs) are well-positioned as health advocates, they frequently lack support and feel undervalued. Advocacy training may prepare CHWs to support communities better.</p></sec><sec id="sec2"><title>Methods</title><p>This study uses a design-based research approach to (1) explore how participation in curriculum-development workshops for a digital advocacy course influenced CHWs’ (<italic>n</italic> = 25) perceptions of advocacy and (2) describe how CHW involvement shaped course development. Data were collected via five discussion groups and seven surveys over six months.</p></sec><sec id="sec3"><title>Results</title><p>Initially, the CHWs perceived themselves as community-advocates but not as self-advocates. They increasingly reflected on the merits of advocating for better working conditions and aspired to greater involvement in decision-making. CHWs reflected positively on their advisory role in shaping the course to improve content acceptability and validity.</p></sec><sec id="sec4"><title>Discussion</title><p>Training efforts to engage CHWs in advocacy must overcome systemic barriers and norms internalized by CHWs that deter them from reaching their full potential as advocates.</p></sec>