The Role of Alaska’s Tribal Health Workers in Supporting Families

Alaska’s Community Health Aides/Practitioners (CHA/Ps) are often the sole medical workers in their communities in rural Alaska, and are instrumental in providing healthcare services and education to otherwise underserved individuals. This qualitative study explored how CHA/Ps support healthy families. Six CHA/Ps from two rural communities in western Alaska were interviewed about their scope of practice, interactions with mothers, infants, families, and teens, relationship to other medical providers, and perceptions of their work. Using grounded theory, verbatim notes were analyzed in Dedoose software and coded by thematic and structural components. Interviewed CHA/Ps shared how the CHA/P program is a culturally relevant way to deliver healthcare, and talked about the challenges of the work, rewards, and suggestions for improvement. CHA/Ps described their unique role as the on-the-ground health and wellness resource in their communities, and talked about consulting with other medical professionals to provide better care for individuals in rural Alaska. CHA/Ps described that they provided prenatal care, patient education during pregnancy, emergency delivery services when necessary, well-child visits, and outreach to teens to give fluoride rinses, vaccinations, and education about issues such as sexual health and drugs/alcohol. CHA/Ps also talked about patient education as a primary responsibility, which also reduced patient load and prevented burn-out. The CHA/P program is a comprehensive and innovative approach to providing healthcare education and services that promotes healthy communities, including positive parent-infant interactions, child wellness, and teen decision-making. The program is a healthcare delivery model translatable to other tribal and limited-resource contexts.