Addressing Hispanic Obesity Disparities Using a Community Health Worker Model Grounded in Motivational Interviewing

2021 ◽  
pp. 089011712110496
Author(s):  
Louis D. Brown ◽  
Denise Vasquez ◽  
Diane I. Lopez ◽  
Erin M. Portillo
Keyword(s):  
Motivational Interviewing ◽  
Community Health ◽  
Health Workers ◽  
Low Cost ◽  
El Paso ◽  
Bioelectrical Impedance ◽  
Fat Percentage ◽  
Phone Calls ◽  
Initial Intervention ◽  
Quasi Experimental

Purpose To determine whether Hispanic residents receiving the Healthy Fit intervention enhanced with Motivational Interviewing (MI) experienced greater improvements in body composition, relative to participants receiving the initial intervention. Design Quasi-experimental evaluation. Setting El Paso, Texas. Sample Among 656 baseline participants, 374 (54%) completed the 12-month assessment. Intervention In Healthy Fit, community health workers (CHWs) promote nutrition and exercise. To strengthen intrinsic motivation and help participants overcome barriers to change, we incorporated a 30-minute motivational interview into the baseline assessment. Follow-up phone calls at 1, 3, and 6 months were identical across conditions. Measures CHWs assessed body mass index (BMI) and body fat percentage (BFP) using a bioelectrical impedance scale. Analysis Regression models estimated differences between intervention conditions on change in BMI and BFP from baseline to the 12-month assessment. Results Participants receiving MI had 2.13 times higher odds of losing weight (OR = 2.14, 95% CI [1.30, 3.53], P = .003) and 2.59 times higher odds of reduced BFP (OR = 2.59, 95% CI [1.51, 4.41], P < .001), relative to initial intervention participants. MI participants lost an average of 1.23 kg (2.71 lbs.) and their BFP declined 2% over 12 months. Conclusion Findings suggest CHW use of MI is a promising approach for promoting incremental changes in diet and exercise, which Healthy Fit integrates into a low-cost intervention.

Brief Motivational Interviewing Training for Outreach in School Health Programming

2021 ◽  
Vol 36 (1) ◽  
Author(s):  
Kathryn J. DeShaw ◽  
Laura D. Ellingson ◽  
Laura Liechty ◽  
Gabriella M. McLoughlin ◽  
Gregory J. Welk
Keyword(s):  
Motivational Interviewing ◽  
Training Program ◽  
School Health ◽  
Effect Sizes ◽  
Extension Field ◽  
School Wellness ◽  
Phone Calls ◽  
Quasi Experimental ◽  
Health Programming ◽  
Training Protocol

This study assessed a brief 6-week motivational interviewing (MI) training program for extension field specialists (EFS) involved in supporting a statewide school wellness initiative called SWITCH. A total of 16EFS were instructed in MI principles to support the programming and half (n = 8) volunteered to participate in the hybrid (online and in-person) MI training program. Phone calls between EFS and school staff involved in SWITCH were recorded and coded using the Motivational Interviewing Treatment Integrity (MITI) system to capture data on utilization of MI principles. Differences in MI utilization between the trained (n=8) and untrained (n=8) EFS were evaluated using Cohen’s d effect sizes. Results revealed large differences for technical global scores (d=1.5) and moderate effect sizes for relational global components (d=0.76) between the two groups. This naturalistic, quasi-experimental study indicates a brief MI training protocol is effective for teaching the spirit and relational components of MI to EFS.

Community Health Workers (CHWs) as Innovators

2018 ◽  
Vol 13 (1) ◽  
pp. 15-28
Author(s):  
Tyler Prentiss ◽  
John Zervos ◽  
Mohan Tanniru ◽  
Joseph Tan
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Underserved Populations ◽  
Low Cost ◽  
Cost Effective ◽  
Well Being ◽  
Grant Writing ◽  
Multiple Sources ◽  
Context Of Learning

Community health workers (CHWs) have a longstanding role in improving the health and well-being of underserved populations in resource-limited settings. CHWs are trusted in the communities they serve and are often able to see through solutions on community challenges that outside persons cannot. Notwithstanding, such solutions often must be low-cost, easily implementable, and permit knowledge gaps among CHWs to be filled via appropriate training. In this sense, use of cost-effective information technology (IT) solutions can be key to increasing access to knowledge for these community agents. This paper highlights insights gleaned from a pilot study performed in Detroit, Michigan with a group of CHWs in basic grant-writing training via an e-platform, the Community Health Innovator Program (CHIP). The results are discussed within the context of learning theory. It is concluded that e-platforms are necessary for CHWs to leverage knowledge from multiple sources in an adaptive environment towards addressing ever-evolving global health challenges.

scholarly journals Effect of supervision and education on community health workers performance in the field of primary health care

2020 ◽  
Vol 7 (2) ◽  
pp. 437
Author(s):  
Seyede Sakine Hasani Ziabari ◽  
Sareh Shakerian
Keyword(s):  
Health Care ◽  
Community Health ◽  
Community Health Workers ◽  
Health Care Providers ◽  
Health Workers ◽  
Care Providers ◽  
Reform Plan ◽  
Post Test ◽  
Quasi Experimental ◽  
Effective Supervision

Background: Effective supervision strategies help to address the challenges unique to community health workers (CHWs) or Behvarz and improve poor practices. Current research is comparing situation of two supervisors group on performance of CHWs in Lahijan city.Methods: This study was done through a quasi-experimental method in which with census it was considered through pre and post-test after education, then the statistical society was divided through systematic random sampling method and was supervised by two supervisor groups (health care providers and headquarters experts) and their situation were compared using the standard performance checklist in 10 primary healthcare fields for a four month period.Results: Education section showed that 120 CHWs of statistical society, 56 CHWs of capability (in pre-test) answered 70% of questions correctly and in post-test 83 CHWs have answered to 70% of questions correctly and totally it shows 34% of enhancement. Result of in performance section showed that 63% CHWs under supervision of health care providers could have performance higher than 70% in 10 fields. Also result showed that 73% CHWs supervised by headquarter experts could have performance higher than 70% in 10 fields.Conclusions: The effect of the education and supervision on the performance increased although with little difference in the two groups of observers. It can be concluded that the only field that is fully specialized after the implementation of Health Reform Plan is the field of pregnant mothers who provide services to this highly specialized group through midwives. 

scholarly journals The use of low-cost ruggedized Android tablets to augment in-service training of community health workers in Mukono, Uganda: perspectives and lessons learned from the field

2021 ◽  
Vol 21 (3) ◽  
pp. 1482-1490
Author(s):  
Christina E Stiles ◽  
Edward O’Neil Jr ◽  
Kenneth Kabali ◽  
James O’Donovan
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Low Cost ◽  
Local Level ◽  
Scale Up ◽  
Lessons Learned ◽  
Sub Saharan Africa ◽  
Refresher Training ◽  
Service Training

Background: Despite potential for community health workers (CHWs) to effectively reduce morbidity and mortality in sub-Saharan Africa, they still face multiple barriers including access to on-going and refresher training. Digital technology offers a potential solution to improve the provision of ongoing training for CHWs. Objectives: This report shares participant insights and experiences following the implementation of a mobile health (mHealth) assisted Integrated Community Case Management (iCCM) refresher training programme for CHWs in Mukono, Uganda. We seek to document benefits and challenges of such an approach. Methods: CHWs were trained to recognize, treat and prevent childhood pneumonia via locally made videos preloaded onto low cost, ruggedized Android tablets. Subsequent interviews were compiled with key stakeholders including CHWs, CHW leaders and programme supervisors to better understand the strengths, barriers and lessons learned following the interven- tion. Results: Success factors included the establishment of CHW leadership structures, the ability to use the tablets to learn on an “any pace, any place” basis and using the tablets to conduct community teaching and outreach. Barriers included appro- priate consideration of the implementation timeline and avoiding a “one size fits all” approach to digital literacy training. Conclusions: The strength of the program stemmed from a grassroots approach that prioritized stakeholder input at all stages. Leadership at a local level, a history of local engagement and trust built up over a period time were also integral. As organizations aim to scale up digitally enhanced training initiatives, it is paramount that attention is paid to these human factors which are key for program success. Keywords: Low-cost ruggedized Android tablets; in-service training; community health workers; Mukono.

scholarly journals Acceptability and Impact of Group Interpersonal Therapy (IPT-G) on Kenyan Adolescent Mothers Living with HIV: A Qualitative Analysis

2020 ◽  
Author(s):  
Obadia Yator ◽  
Lincoln Khasakhala ◽  
Grace John Stewart ◽  
Manasi Kumar
Keyword(s):  
Mental Health ◽  
Community Health ◽  
Adolescent Mothers ◽  
Health Workers ◽  
Instant Messaging ◽  
Task Shifting ◽  
Wait List ◽  
Wait List Group ◽  
Phone Calls ◽  
Living With Hiv

Abstract Background Task shifting is a well-tested implementation strategy, within low- and middle-income countries (LMICs), that addresses the shortage of trained mental health personnel. Task sharing can increase access to care for patients with mental illnesses. In Kenya, community health workers [CHWs are a combination of community health assistants (CHAs) and community health volunteers (CHVs)], have played a crucial role in this front. In our study, we seek to assess the acceptability and feasibility of IPT-G delivered by CHWs among depressed postpartum adolescents (PPAs) living with HIV.Method Twenty-four PPAs were administered IPT-G by trained CHWs from two health centers. A two-arm study design (IPT-G intervention and treatment as usual) with an intent to treat was used to assess acceptability and feasibility of IPT-G. Participants who scored >10 on Edinburgh postnatal depression scale (EPDS) and who were 6–12 weeks postpartum were eligible for the study using purposeful sampling. Participants were equally distributed into two groups: one group for intervention and another for wait-list group. This was achieved by randomly allocating numerical numbers and separating those with odd numbers (intervention group) and even numbers (wait-list group). Focus group discussions (FGDs) and in-depth interviews ascertained the experience and perceptions of the postpartum adolescents and the CHWs. In addition to weekly face-to-face continuous supportive supervision for CHWs, phone calls, short messages services, and WhatsApp instant messaging services were also utilized.Results The CHWs found the intervention useful for their own knowledge and skill-set. On participation, 21out of the 24 adolescents attended all sessions. Most of the adolescents reported improvement in their interpersonal relationships with reduced distress and lessening of HIV-related stigma. Primary health care workers embraced the intervention by availing space for sessions. Conclusion Our study demonstrates possible benefits of task shifting in addressing mental health problems within low-resource settings in Kenya and group IPT is demonstrated to be both acceptable and feasible by health workers and adolescents receiving care.

scholarly journals Evaluation of a training program for soft skill education and financial literacy to community health workers in India: a quasi-experimental study

2020 ◽  
Author(s):  
Shantanu Sharma ◽  
Kanishtha Arora ◽  
Chandra Shekhar ◽  
Rajesh Kumar Sinha ◽  
Faiyaz Akhtar ◽  
...  
Keyword(s):  
Community Health ◽  
Training Program ◽  
Financial Literacy ◽  
Life Skills ◽  
Health Workers ◽  
Intervention Group ◽  
Group Factor ◽  
Self Confidence ◽  
Post Test ◽  
Quasi Experimental

Abstract Background: Accredited Social Health Activists (ASHA) are community health workers responsible for improving the health status of people by facilitating their access to healthcare services. The life skills of ASHA are known to be effective in negotiating behaviour change in the community; however, there has been a meagre focus towards improving them. Considering this gap, we adopted a comprehensive training program, known as Personal Advancement and Career Enhancement (P.A.C.E.), to empower ASHAs on life skills and financial literacy. The present study intends to assess the training program in two districts of Uttar Pradesh, India, by examining changes in knowledge, perceptions, and practices of ASHAs about life skills and financial literacy.Methods: We conducted a quasi-experimental, non-randomized, controlled study with pre- and post-test assessments. Data were collected on socio-demographic characteristics, knowledge, and practices related to life skills (communication skills, self-confidence, problem–solving and decision-making skills, time and stress management skills) and financial literacy. Additionally, perceptions regarding changes in practices related to gender issues, life skills, and savings at the personal, community, and workplace levels were obtained from the intervention group. Factor analysis was performed to obtain the change patterns by assessing the degree to which the four domains of life skills, financial literacy, and domains of perceptions of change in practices were correlated to each other. A general linear regression model was performed to assess associations among change pattern scores and socio-demographic variables.Results: The data of 171 ASHA were analyzed (intervention group:86 and control group:85). There was a significant improvement in the average post-test scores of all the life skills and financial literacy in the intervention group (p<0.001). Three distinct change patterns were found post-training in the intervention group. Factor 1 (high loadings for perceptions related to change in practices) was positively associated with ASHAs aged 38 and above and with experience of ≤12 years. On the contrary, the change in financial literacy and self-confidence scores was common among ASHAs with more than 12 years of experience.Conclusions: The P.A.C.E training program was found effective in improving the life skills and financial literacy of ASHAs in India.

scholarly journals Evaluation of a training program for soft skill education and financial literacy to community health workers in India: a quasi-experimental study

2020 ◽  
Author(s):  
shantanu sharma ◽  
Kanishtha Arora ◽  
Chandrashekhar Chandrashekhar ◽  
Rajesh Kumar Sinha ◽  
Faiyaz Akhtar ◽  
...  
Keyword(s):  
Community Health ◽  
Training Program ◽  
Financial Literacy ◽  
Health Workers ◽  
Soft Skills ◽  
Intervention Group ◽  
Group Factor ◽  
Self Confidence ◽  
Post Test ◽  
Quasi Experimental

Abstract Background The soft skills of community health workers (Accredited Social Health Activists, ASHA) are known to be effective in negotiating behaviour change in the community; however, there has been a meagre focus towards improving them. Considering this gap, we adopted a comprehensive training program, known as Personal Advancement and Career Enhancement (P.A.C.E.), to empower ASHAs on soft skills and financial literacy. The present study intends to assess the training program in two districts of Uttar Pradesh, India, by examining changes in knowledge, perceptions, and practices of ASHAs about soft skills and financial literacy. Methods We conducted a quasi-experimental, non-randomized, controlled study with pre- and post-test assessments. Data were collected on socio-demographic characteristics, knowledge, and practices related to soft skills (communication skills, self-confidence, problem–solving and decision-making skills, time and stress management skills) and financial literacy. Additionally, perceptions regarding changes in practices related to gender issues, soft skills, and savings at the personal, community, and workplace levels were obtained from the intervention group. Factor analysis was performed to obtain the change patterns by assessing the degree to which the four domains of soft skills, financial literacy, and domains of perceptions of change in practices were correlated to each other. A general linear regression model was performed to assess associations among change pattern scores and socio-demographic variables. Results The data of 171 ASHAs were analyzed (intervention group:86 and control group:85). There was a significant improvement in the average post-test scores of all the soft skills and financial literacy in the intervention group (p<0.001). Three distinct change patterns were found post-training in the intervention group. Factor 1 (high loadings for perceptions related to change in practices) was positively associated with ASHAs aged 38 years and above and with experience of ≤12 years. On the contrary, the change in financial literacy and self-confidence scores was common among ASHAs with more than 12 years of experience. Conclusions The P.A.C.E training program was found effective in improving the soft skills and financial literacy of ASHAs in India.

scholarly journals Effectiveness of screening and treatment of children with severe acute malnutrition by community health workers in Simiyu region, Tanzania: a quasi-experimental pilot study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Calistus Wilunda ◽  
Fortihappiness Gabinus Mumba ◽  
Giovanni Putoto ◽  
Gloria Maya ◽  
Elias Musa ◽  
...  
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Severe Acute Malnutrition ◽  
Intervention Group ◽  
Control Area ◽  
Acute Malnutrition ◽  
Control Group ◽  
Treatment Coverage ◽  
Quasi Experimental

AbstractHealth system constraints hamper treatment of children with severe acute malnutrition (SAM) in Tanzania. This non-inferiority quasi-experimental study in Bariadi (intervention) and Maswa (control) districts assessed the effectiveness, coverage, and cost-effectiveness of SAM treatment by community health workers (CHWs) compared with outpatient therapeutic care (OTC). We included 154 and 210 children aged 6–59 months with SAM [mid-upper arm circumference (MUAC) < 11.5 cm] without medical complications in the control and intervention districts, respectively. The primary treatment outcome was cure (MUAC ≥ 12.5 cm). We performed costing analysis from the provider’s perspective. The probability of cure was higher in the intervention group (90.5%) than in the control group (75.3%); risk ratio (RR) 1.17; 95% CI 1.05, 1.31 and risk difference (RD) 0.13; 95% CI 0.04, 0.23. SAM treatment coverage was higher in the intervention area (80.9%) than in the control area (41.7%). The cost per child treated was US$146.50 in the intervention group and US$161.62 in the control group and that per child cured was US$161.77 and US$215.49 in the intervention and control groups, respectively. The additional costs per an additional child treated and cured were US$134.40 and US$130.92, respectively. Compared with OTC, treatment of children with uncomplicated SAM by CHWs was effective, increased treatment coverage and was cost-effective.

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