Methods: We analyzed cross-sectional survey data from 159 CBPs, who identify as CHWs or HVs, which was collected using the Qualtrics platform. Descriptive statistics were performed to characterize our sample and show the distribution of service types. Logistic regression was used to identify salient organizational (job satisfaction: communication, contingent rewards, fringe benefits, operating conditions, and coworker; and training helpfulness) and individual characteristics (self-efficacy) that are associated with service integration.
Results: The majority of participants (n=70, 44.03%) integrated all four of the services: mental health, IPV, sexual health and mental health services. Training helpfulness (b=-2.48, p=0.0089), self-efficacy (b=0.0682, p<0.001), and job satisfaction (b=-0.0361, p=0.0114) were significantly associated with provision of integrated services. Specifically, elements of job satisfaction that were associated with integrated service provision included satisfaction with communication (b=-0.2792, p=0.0047), and coworkers (b=-0.2929, p=0.0043).
Conclusion: For the first time, integrated service provision was conceptualized to include sexual health, substance use, IPV and mental health services, a formulation that is responsive to the well-established linkage between clients of home visiting services and vulnerability to these conditions. Having demonstrated empirically that there are specific levers within the scope of work conditions that can be activated to promote integrated services allows human services organization leadership (many of whom are social workers), workforce policy advocates, and legislators to consider strategies to invest in training and innovative supervisory tools that are responsive, tailored, and specific to the needs of this workforce, rather than a broad one-size-fits all approach.