The Narratives of Natural Helpers: a Qualitative Exploration of the Lived Experiences of Community Health Workers in Alabama

Alabamian access to healthcare is declining in rural areas and rural hospitals are experiencing monetary loss in services due to the high cost in service delivery and low insurance reimbursements. CHWs may complement an under-resourced and over-stretched health workforce, increasing the availability and access to health services. This study aimed to explore the lived experiences and personal knowledge of CHWs in Alabama, share their stories of community impact, and inform CHW employers and decision-makers to guide policy development and training. The research questions that guided this study include: How do lived experiences and personal knowledge of CHWs in Alabama (a) influence their decision to join the CHW workforce, (b) contribute to their ability to work successfully in the field, and (c) influence their motivation to continue in the field? What professional and community-focused aspirations do CHWs in Alabama have for themselves? In what ways do CHWs in Alabama understand their professional identity? How do CHWs in Alabama understand and respond to the contextual messages they receive about their professional role? What challenges and successes do CHWs in Alabama experience as they understand their professional role? Seven CHWs were recruited using purposive sampling and shared their stories in individual online interviews. The findings illuminate the caring nature of CHWs, curiosity as a motivator, and the value CHWs place in having a network of support. Analysis revealed four themes and 12 sub-themes. This study provides insights into the meaning of the CHW role to CHWs in Alabama through their lived experiences.