Elizabeth Palu, Kate A McBride, David Simmons, Ronda Thompson, Cassandra Cavallaro, Ellen Cooper, Makeleta Felila, Freya MacMillan
Adequacy of health message tailoring for ethnic minorities: Pasifika communities in Sydney, Australia, during COVID-19
Health promotion international
community health workers chws play important role health systems low middleincome countries including south africa bukhali chwdelivered intervention part randomised controlled trial improve health trajectories young women soweto south africa study aimed qualitatively explore factors influencing implementation preconception pregnancy phases bukhali perspective chws health helpers hhs delivering intervention part bukhali trial process evaluation three focus group discussions conducted 13 hhs employed trial thematic approach used analyse data drawing elements reflexive thematic codebook approach following six themes developed representing factors impacting implementation hh roles interaction existing public healthcare sector participant perceptions health health literacy language barriers participants socioeconomic constraints family partner community views trial components hhparticipant relationship hhs reported uses several trialbased tools overcome implementation challenges increasing ability implement roles planned relationship trust hh participants seemed function one important mechanism impact findings supported number adaptations implementation bukhali intensified trialbased followup referrals receive management clinics continued hh training community engagement parallel trial implementation increased emphasis healthrelated stigma education hh perspectives intervention implementation highlighted adaptations across three broad strategic areas navigating bridging healthcare systems adaptability individual participant needs navigating stigma around disease findings provide recommendations next phases bukhali chwdelivered preconception pregnancy trials strengthening chw roles clinical settings similar implementation challenges trial registration pan african clinical trials registry pactr201903750173871 registered march 27 2019