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=Volume 12 - 2024

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=Introduction: 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.Methods: This study uses a design-based research approach to (1) explore how participation in curriculum-development workshops for a digital advocacy course influenced CHWs' (n=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.Results: Initially, the CHWs perceived themselves as community-advocates but not as selfadvocates. 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.Discussion: 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.