CONTEXT: The Community Health Aide Program (CHAP) is a unique program employing local, indigenous peoples as primary care nonphysician providers in extremely remote frontier, tribal Alaskan communities. With attrition rates up to 20%, recommendations for improving retention are necessary to maintain access to health services for Alaska Natives in these communities. PURPOSE: The purpose of this study was to identify factors contributing to retention in Alaska's CHAP program. METHODS: Key informant interviews were conducted with 41 community health aides/practitioners (CHA/Ps) in 15 villages statewide. Efforts were made to ensure the sample included a mix of villages with high retention of health aides and villages with lower retention. Geographic and ethnic diversity were also considered. Transcripts were coded using NUD*IST software, and data were analyzed for differences between high retention and low retention villages and between more experienced and less experienced CHA/Ps. FINDINGS: Five fundamental needs of health aides were identified as crucial for retention of personnel. These needs include strong co-worker support, access to basic training, a fully staffed clinic, good community support, and supportive families. CONCLUSIONS: For 35 years, the CHAP program has worked to diminish health disparities for Alaska Natives. Though unique challenges associated with the job have factored into low retention of CHA/Ps, improved retention is possible with easier access to basic training, increased support from colleagues and community, enhanced team-building skills, and better on-call schedules.
CONTEXT: The Community Health Aide Program (CHAP) is a unique program employing local, indigenous peoples as primary care nonphysician providers in extremely remote frontier, tribal Alaskan communities. With attrition rates up to 20%, recommendations for improving retention are necessary to maintain access to health services for Alaska Natives in these communities. PURPOSE: The purpose of this study was to identify factors contributing to retention in Alaska's CHAP program. METHODS: Key informant interviews were conducted with 41 community health aides/practitioners (CHA/Ps) in 15 villages statewide. Efforts were made to ensure the sample included a mix of villages with high retention of health aides and villages with lower retention. Geographic and ethnic diversity were also considered. Transcripts were coded using NUD*IST software, and data were analyzed for differences between high retention and low retention villages and between more experienced and less experienced CHA/Ps. FINDINGS: Five fundamental needs of health aides were identified as crucial for retention of personnel. These needs include strong co-worker support, access to basic training, a fully staffed clinic, good community support, and supportive families. CONCLUSIONS: For 35 years, the CHAP program has worked to diminish health disparities for Alaska Natives. Though unique challenges associated with the job have factored into low retention of CHA/Ps, improved retention is possible with easier access to basic training, increased support from colleagues and community, enhanced team-building skills, and better on-call schedules.
Authors: Sherie Lou Z Santos; Erin K Tagai; Min Qi Wang; Mary Ann Scheirer; Jimmie L Slade; Cheryl L Holt Journal: Am J Public Health Date: 2014-10-16 Impact factor: 9.308
Authors: Lisa G Dirks; Jennifer L Shaw; Vanessa Y Hiratsuka; Julie A Beans; Janet J Kelly; Denise A Dillard Journal: J Community Genet Date: 2019-01-30
Authors: Sara Javanparast; Fran Baum; Ronald Labonte; David Sanders; Zohreh Rajabi; Gholamreza Heidari Journal: BMC Health Serv Res Date: 2012-08-31 Impact factor: 2.655
Authors: David Peiris; Alex Brown; Michael Howard; Bernadette A Rickards; Andrew Tonkin; Ian Ring; Noel Hayman; Alan Cass Journal: BMC Health Serv Res Date: 2012-10-28 Impact factor: 2.655