## 3 Results
### The Program Mechanisms That Produce Outcomes
#### 3.3.2 Equality  
**CHWs and clients developed a real connection, from human to human.** Almost all participants stated that CHWs were offering \"something else\" compared to formal caregivers. Many participants identified that this aspect of real human contact is crucial for the CHW intervention. By contrast, patients mainly see professional caregivers as high-ranked experts responsible for their patients' health and wellbeing.  
Figure 2: Contextual factors and program mechanisms producing outcomes.  
_I think it's mostly the fact that ordinary people can help. That she also felt \"That's not a doctor or nurse here but just someone who calls to ask how I'm doing\"._  
(CHW 2)  
_I'm voluntary. I only come to listen and to chat. That is something different from what you (professional caregivers) can already give to that lady. I'll give something else. I am a human being, she tells what is on her mind. And I try to listen and say something once at a time--but in the meantime, I'm not deciding about her life._  
(CHW 1)  
_I think the big difference lies in the fact that the contact is from person to person. There's nothing attached to it. It costs zero euros. Nothing is obligatory. It's not a mandatory therapy and you shouldn't get anywhere. It is non-committal. It is authentic. I think there is a very big difference there, that you have that buffer. That you are not immediately professionally valued as \"Something is wrong with you\"._  
(CHW 5)  
**CHWs are \"on the same level\" as the clients they guide.** This aspect of equality enables CHWs to gain trust. Moreover, the difference in social status and 'not being on the same level' between formal caregivers and their vulnerable patients can sometimes make them less accessible for people with a vulnerable background to share their full stories for fear of not being understood, as stated by many participants. 'Not being part of the system' can also foster trust by a feeling of safety. Being clear to clients about their volunteering status, CHWs can also set proper expectations of their role and unconditional commitment.  
_The doctor-patient relationship is something else. They're higher. She just says X and I say Y. There is no title. I mean, there's no hierarchical difference. We just sit on a bench together to chat._  
(CHW 6)  
_I think that does give more confidence. Because we're just going somewhere next to and with those people. And sometimes it scares people off when you say \"I'm a doctor\". I think people might automatically start to conceal things or their lifestyle. I have found that people speak more easily. Like when walking: we walk next to each other, it is quiet and automatically they tell something more. Then sometimes things come up._  
(CHW 3)  
**An unprejudiced stranger can offer a safe interaction to share personal stories and concerns without judging.** Some participants expressed that CHWs are neutral and can offer a new external perspective that can be a breath of fresh air in often complex cases.  
_I think the barrier is smaller for some people. That they can tell someone else about their concerns instead of their own children or their partner, who have already heard it all. I think sometimes it's easier to be open to people who aren't that close to you._  
(CHW 2)  
_Another person (an outsider) just listens and another person will not draw any conclusions or judge._  
(CHW 7)