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  1. Carson, Savanna L. PhD
  2. Hong, Clemens MD, MPH
  3. Behforouz, Heidi MD
  4. Chang, Emily MD
  5. Dixon, Lydia Z. PhD
  6. Factor, Diane MS
  7. George, Sheba M. PhD
  8. Lewis, Jenebah MSW, LCSW
  9. Majeno, Angelina MPH
  10. Morales, Maria BA
  11. Porter, Courtney BS
  12. Shah, Ami MPH
  13. Vassar, Stefanie D. MS
  14. Brown, Arleen F. MD, PhD


Medically and socially complex patients disproportionately face barriers to primary care, contributing to health inequities and higher health care costs. This study elicited perspectives on how community health workers (CHWs) act upon barriers to primary care in 5 patient (n = 25) and 3 CHW focus groups (n = 17). Participants described how CHWs acted on patient-level barriers through social support, empowerment, and linkages, and system-level barriers by enhancing care team awareness of patient circumstances, optimizing communication, and advocating for equitable treatment. Limitations existed for influencing entrenched community-level barriers. CHWs, focusing on patient preferences, motivators, and circumstances, intervened on multilevel barriers to primary care, including advocacy for equitable treatment. These mechanisms have implications for existing CHW conceptual models.