Author ORCID Identifier

https://orcid.org/0000-0003-4556-702X

Year of Publication

2020

Degree Name

Doctor of Philosophy (PhD)

Document Type

Doctoral Dissertation

College

Communication and Information Studies

Department

Communication

First Advisor

Dr. Jeffrey T. Huber

Abstract

Despite successful efforts to treat and manage diseases, public health officials have recently begun a campaign to refocus efforts toward initiatives to alleviate the pressures that are often referred to as social determinants of health. In eastern Kentucky, and in other geographical regions labeled as health professional shortage areas or medically underserved areas, issues stemming from social determinants are compounded with health care systems that are often lacking the human resources to meet basic medical needs. One strategy has been to utilize volunteers and paraprofessionals such as community health workers to lessen the burden on the primary care and hospital systems. Community health workers are frontline public health workers who are trusted members of their communities and who serve to connect their clients to health and social services (American Public Health Association, 2009). Now more than ever, community health workers are seen as an integral piece to providing comprehensive and patient-centered care. The purpose of this study is to, ultimately, better understand the information practices of community health workers in Eastern Kentucky in order for the health science and public library communities to position themselves to better serve this population of health professionals. Two research questions will serve to inform this overall goal: (1) what are the information practices of the Kentucky Homeplace community health workers? And, (2) what is the role of information communication technologies - such as mobile phones, computers, and the internet - in the access and management of information by Kentucky Homeplace community health workers?

This study is a qualitative investigation, utilizing multiple methods, seeking to understand the information practices of Kentucky Homeplace community health workers. Semi-structured, in-depth interviews and participant observation with community health workers have been conducted. Conceiving information needs, seeking, barriers, and uses as practices requires the recognition that social practices are located within microcosms which, in turn, situated within meso- and macrocosmic communities, and as such, practices are socio-cultural and political. To understand the socio-cultural context and political ecology in which community health workers operate, semi-structured, in-depth interviews have been conducted with community health worker administrators, state public health officials, and leaders from the statewide community health worker association. To further understand the socio-cultural and political context, this study has conducted thematic content analysis with documents critical to the construction of community health workers’ roles, responsibilities, and authority. Finally, to fully understand the information environment in which community health workers operate, semi-structured interviews have been conducted with directors of public libraries in the 30-county area Kentucky Homeplace covers as well as librarians from regional academic and health science libraries. In total, 6 interviews were conducted with community health workers, 3 interviews were conducted with library directors and/or librarians, and 4 interviews, combined, were conducted with community health worker administrators and individuals from the Kentucky Department for Public Health. A total of 8 hours, 39 minutes, and 47 seconds of interview time was recorded. 16 hours of participant observation was conducted with two community health workers, across two days.

The community health workers in this study articulated information needs that related to client information, information about services and resources in their communities, information about services and resources available independent of location, and health information for themselves and for their clients or clients’ caregivers. While some of this information was sought after through information communication technologies, community health workers also indicated that they often seek information through interaction with other community health workers, and with representatives from community organizations. Community health workers function as interstitial agents, crossing boundaries between organizations, or between societal levels. The information that they create, seek, process, and disseminate functions as a boundary object. To do this, community health workers utilize a wide range of information communication technologies including modern modalities such as computers, the world wide web, email listservs, and shared servers, in addition to conventional modes of communication such as the phone, business cards, and printed pamphlets. Ultimately, the role of the community health worker is as an infomediary, positioned to facilitate the flow or exchange of information from one body to another.

Digital Object Identifier (DOI)

https://doi.org/10.13023/etd.2020.114

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