Predictors of Job Satisfaction Among Community Health Workers Offering Maternal and Infant Care in New York

Background: With the recent government investment in the community and public health work, community health works (CHWs) are playing an important role in improving the health outcomes of otherwise difficult to reach populations. To continue to retain, expand and improve this workforce, it is imperative to understand the mechanisms of job satisfaction in community health workers.

Methods: Using cross‐sectional data from 75 CHWs employed in 14 agencies funded through the Maternal and Infant Community Health Collaboratives Initiative (MICHC) in New York, our study examined predictors (role clarity, self-efficacy, burnout, secondary stress trauma, compassion fatigue, demographic characteristics) to job satisfaction. Using a complete case analysis, descriptive statistics were used to characterize our sample. Linear regression was used to investigate the correlates of job satisfaction and its nine-facets. Statistical significance was set at p < 0.05. All analyses were conducted using SAS 9.4.

Results: Most participants identified as non-Hispanic (78.05%), White (63.41%), female (96.34%), and were on average 39 years old (SD = 11.4082557). Most participants had completed a bachelor’s (41.46%) and about 73.17% made a gross annual income between $25,000 - 49,999 and 30.49% participants had been in their current position for more than 5 years. Higher role clarity (β = 1.5855, p < 0.001) and lower burnout scores (β = -1.337, p=0.0336) were significantly associated with job satisfaction. Role clarity remained a significant correlate for most job satisfaction domains. In terms of satisfaction with communication, working more than 35 hours (β = 1.99708, p=0.0086), role clarity (β =0.20428, p=0.0003), and higher education (β = 1.05409, p=0.0029) were positively associated. Higher role clarity (β = 0.26899, p = 0.0002) and lower burnout scores (β = -0.33676, p= 0.0062) were significantly associated with satisfaction with contingency rewards. Higher role clarity (β = 0.09907, p = 0.0499), lower burnout (β = -0.21169, p = 0.0193), and higher compassion scale (β = 0.22723, p = 0.0012) were significant correlates of satisfaction with nature of work. For operating conditions, higher role clarity (β = 0.24081, p = 0.0005) and higher income (β = 1.20475, p = 0.0456) were significant correlates. For satisfaction with promotions, higher role clarity (β = 0.17951, p = 0.03) and higher self-efficacy (β = 0.06844, p = 0.0112) were important factors. Role clarity (β = 0.13167, p = 0.0254) and more work management strategies related to their supervisor (β = 1.19489, p = 0.0041) were associated with higher satisfaction with their supervisor. For satisfaction with coworkers (β = 0.2599, p = 0.0007) and pay (β = 0.1674, p = 0.0257), only role clarity was a significantly covariate. And for fringe benefits, only income was significantly associated (β = 1.53657, p = 0.0225).

Discussion: Our study findings guide changes in practice that improve CHW wellbeing and support their ability to address health inequities. There is a need to focus on clearer job descriptions for clarity in CHW roles, greater well-being on CHWs and supports for CHW supervisors.