Table 3.

There were six key themes from provider, staff, and CHA interviews and focus groups on the perspectives of the CHA role, and what factors enabled his or her success.

Themes	Quotes from practice staff
CHAs with shared life experiences as patients	“I have experienced working with the patient and the patient is hesitant to tell me their social needs (female CHA talking about male population). Machismo is very established and I'm a 5'1 female, every time I have a new male patient referred by a male friend I'm surprised.” – CHA “When you are looking for a health advocate, I think diversity is really important. And that really expands the outreach to different patients, depends on their ethnicity, their language. The CHA helped me a lot to reach out to patients where language was the biggest issue.” – Provider “Our CHA has a social services background, and a military background. He has had much success connecting patients to Veteran services. He has experience with homeless populations, and he has had much success with housing, and food services.” – Practice staff
Establishing role clarity at the practice	“There was not a lot of information for all staff at the practices on the role of the CHA prior to implementation” and “the first day I showed up and the clinic staff didn't know what the position was.”– CHA “For me, it felt nebulous because we weren't totally sure how to use the CHA. What the actual role would be.” – Provider
Increased understanding of patient populations' social needs	“This (CHA) is one of those things I didn't really believe in. I was not an enthusiastic adopter. I was foolish. I thought people were doing better than they are, and I was wrong.” – Provider
Primary Care vs. Specialty Care Practices	N/A
Improved patient engagement with their health and care	CHAs “give the patients a lifeline and a personal number they can call.” – CHA “What [CHA] has done is go into the community and find the resources that are already there, but they are different bodies not really connected to each other. She went to a place where resources were available, she brought those resources into my clinic…the doctor is telling them to eat healthy, now this CHA is telling them where they can get these foods.” – Provider
Impact of COVID on social needs and CHA response	“Whatever routine the patient had before has mostly been put on hold. Causing tremendous stress.” – CHA ”We want to create a trusting relationship and because of the relationship (with the CHA) we've mitigated the need for some patients to be hospitalized." – Practice staff