Meeting demands & bridging gaps: The relationship between market characteristics and the utilization of enabling services in Federally Qualified Health Centers.

Authors

Shanequa S Roscoe-Nelson, Nancy Borkowski, Monica Aswani, Philip Cendoma, Michelle Brown, Geoffrey A Silvera

Published in

Health care management review. Volume 51. Issue 4. Pages 284-294. Epub Jul 10, 2026.

Abstract

Health education and community outreach provided through enabling services help increase access to care, promote preventive services, and improve health outcomes. Given the vulnerable populations served by Federally Qualified Health Centers (FQHCs), it is critical to examine how resources, like enabling services staffing, are utilized to address patient needs.
This study aimed to explore whether market characteristics indicating resource availability and resource demands are related to the utilization of enabling services workers providing health education and community outreach in FQHCs.
A two-part model using data from the 2022 Uniform Data System (UDS) was conducted to estimate the probability of FQHCs utilizing enabling services workers with logistic regression and the extent of utilization of these workers if present using linear regression.
Study findings revealed variability in resource availability and resource demand factors that are related to the utilization of enabling services workers, with several factors not found to be significant.
The findings suggest that FQHCs may not be sufficiently responsive to patients and community needs or organizational resource levels with the current staffing patterns. This misalignment may lead to negative impacts on patient health outcomes and process measures.
There is a need for policy to prioritize non-clinical support roles and ensure sustainable funding to support the delivery of comprehensive, equitable care to the patients served by FQHCs. There is also a need to understand how other healthcare organizations might be employing resources beyond traditional clinical roles.

PMID:
42635308
Bibliographic data and abstract were imported from PubMed on 24 Aug 2026.

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