Professionalization as a “Double-Edged Sword”: Assessing the Professional Citizenship of Community Health Workers in the Midwest

2021 ◽  
Vol 80 (3) ◽  
pp. 192-202
Author(s):  
Ryan I. Logan
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Well Being ◽  
The United States ◽  
Careful Consideration ◽  
Public Health Programs ◽  
Race Ethnicity ◽  
Health And Well Being ◽  
Improve Health

Community health workers improve health and well-being through, most notably, health education, advocacy, and building individual and community capacity. In spite of these contributions to the health care landscape, these workers are not well integrated within the professional workforce throughout much of the United States. Building on the lens of medical citizenship, I introduce the concept of professional citizenship, which elucidates the belongingness of a group within a professional workforce. Drawing on this framing, I detail the lack of professional belongingness among community health workers in Indiana and the emergent issues that arose via professionalization including: the potential creation of a hierarchy, changes to core roles, and the (in)accessibility of the position due to the requirements for the community health worker certification course. Additionally, I situate these issues within race, ethnicity, gender, and class in examining their effects on the professionalization of these workers. The findings presented in this article can be utilized by policymakers, public health programs, and other employing organizations as community health workers undergo professionalization. Given the poor health outcomes in Indiana, these workers are poised to make significant contributions to the health of their communities—with careful consideration for potential ramifications via professionalization.

scholarly journals 3125 Acceptability of a Narrative Video to Enhance the Use of Genetic Counseling in Latina Women at-risk of Hereditary Breast and Ovarian Cancer: Community Health Worker’s Perspective

2019 ◽  
Vol 3 (s1) ◽  
pp. 80-81
Author(s):  
Alejandra Hurtado de Mendoza ◽  
Kristi Graves ◽  
Sara Gómez-Trillos ◽  
Minna Song ◽  
Lyndsay Anderson ◽  
...  
Keyword(s):  
At Risk ◽  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Underserved Populations ◽  
Community Outreach ◽  
The United States ◽  
Low Literacy ◽  
Patient Navigators ◽  
Latino Community

OBJECTIVES/SPECIFIC AIMS: The goal of the study was to assess the acceptability of a culturally targeted narrative video and identify potential avenues for dissemination in a sample of bilingual community health workers who provide services to the Latino community in the United States. METHODS/STUDY POPULATION: We piloted the video in a sample of bilingual community health workers who provide services to Latinos (n=31). After watching the video, participants filled out a survey. The survey captured sociodemographic data (e.g. education), their role and experience working with Latinos (e.g. patient navigators), acceptability of the video (e.g. general satisfaction, length of the video, amount of information), and potential dissemination (e.g., dissemination channels, preferred settings to watch the video, and preferred context). Three open ended questions captured information about how the video could be useful for the Latino community, what they liked the most from the video, and suggestions for improvement. Data was entered in SPSS version 25. We used descriptive statistics to analyze the survey, and content analysis to summarize the feedback from the open-ended questions. RESULTS/ANTICIPATED RESULTS: Participants (n = 31) had an average age of 46 years (SD=16.99), all self-identified as Hispanic or Latinos, most were female (90.3%), and worked as patient navigators (29%) or community outreach workers (25.8%). The video’s general acceptability was very high. Participants reported high ratings for overall satisfaction, how much they liked the video, enjoyed it, and considered it to be interesting (all means >9.6, range 1-10). Most participants strongly agreed or agreed that the length was adequate (80.7%), that the information presented was very helpful (100%), that the video could be useful for the Latina community (96.8%), and that they would share the video with women at-risk of HBOC (100%). The highest endorsed channels for dissemination were Facebook (90.3) and YouTube (87.1%). The highest endorsed settings were community centers (100%), churches (96.8%), and hospitals (80.6%). Most participants (90.3%) considered that the best context to watch the video would be with relatives, followed by watching with other women at-risk of HBOC (71.0%), friends (71.0%), and lastly by oneself (41.9%) DISCUSSION/SIGNIFICANCE OF IMPACT: This study represents a multidisciplinary approach to intervention development that aims to reduce well-documented knowledge gaps and disparities in the use of GCRA among at-risk Latinas. A culturally targeted video has the potential to reach underserved populations with low literacy and English proficiency and it can be widely disseminated. The video was well received by community health workers who reported high acceptability. These findings are promising given that community health workers could play a key role in the dissemination of the video if it is proven to be efficacious.

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 Not a duty but an opportunity: exploring the lived experiences of community health workers in Indiana through photovoice

2018 ◽  
Vol 2 (3) ◽  
Author(s):  
Ryan I. Logan
Keyword(s):  
Health Care ◽  
Community Health ◽  
Community Health Workers ◽  
Lived Experiences ◽  
Health Workers ◽  
Community Outreach ◽  
The United States ◽  
Health Prevention ◽  
Policy Makers ◽  
Health Care Workforce

Few studies have conducted photovoice projects to explore themes related to the lived experiences of community health workers (CHWs). As a relatively unknown segment of the health care workforce in the United States, CHWs are typically members of the communities they work within and fulfill unique and complementary roles through health education, health prevention, community outreach, and advocacy. This article documents a photovoice project that assessed the strengths, challenges, impacts, and what it means to be a CHW in Indiana. In this project, CHWs participated in the method of photovoice in two formal meetings – one to introduce the method and another to analyze the photographs. Participants displayed photographs, interpreted these images, and co-constructed their lived experiences. Several key themes emerged from discussion of the photographs including: participant descriptions of building individual and character traits, conceptualizations of this position, and how participants connect disparate resources for their clients. Themes and findings from this research can be utilized to reach out to potential employers and policy makers regarding the integration of CHWs into the workforce. Overall, this project documents the lived experiences of CHWs and highlights their voices as they become an accepted member within the broader workforce.

scholarly journals Formerly Incarcerated Community Health Workers Engaging Individuals Returning From Incarceration Into Primary Care: Results From the Transition Clinic Network

2021 ◽  
Vol 9 ◽  
Author(s):  
Jenerius A. Aminawung ◽  
Tyler D. Harvey ◽  
Jerry Smart ◽  
Joseph Calderon ◽  
Anna Steiner ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Outcomes ◽  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Primary Care Clinic ◽  
Social Needs ◽  
Care Clinic ◽  
Primary Care Teams ◽  
Improve Health

Over half a million individuals return from United States prisons and millions more from jails every year, many of whom with complex health and social needs. Community health workers (CHWs) perform diverse roles to improve health outcomes in disadvantaged communities, but no studies have assessed their role as integrated members of a primary care team serving individuals returning from incarceration. Using data from participants who received primary care through the Transitions Clinic Network, a model of care that integrates CHWs with a lived experienced of incarceration into primary care teams, we characterized how CHWs address participant health and social needs during interactions outside of clinic visits for 6 months after participants established primary care. Among the 751 participants, 79% had one or more CHW interactions outside of the clinic documented. Participants with more comorbid conditions, longer stays during their most recent incarceration, and released with a prescription had more interactions with CHWs compared to those with fewer comorbidities, shorter stays, and no prescription at release. Median number of interactions was 4 (interquartile range, IQR 2–8) and 56% were in person. The most common issues addressed (34%) were social determinants of health, with the most common being housing (35%). CHWs working in interdisciplinary primary care teams caring for people with histories of incarceration perform a variety of functions for clients outside of scheduled primary care visits. To improve health outcomes among disadvantaged populations, CHWs should be able to work across multiple systems, with supervision and support for CHW activities both in the primary care clinic and within the community.

scholarly journals Community health workers at the dawn of a new era

2021 ◽  
Vol 19 (S3) ◽  
Author(s):  
Joseph M. Zulu ◽  
Henry B. Perry
Keyword(s):  
Community Health ◽  
Population Health ◽  
Community Health Workers ◽  
Low Income ◽  
Large Scale ◽  
Health Workers ◽  
The United States ◽  
Noncommunicable Diseases ◽  
Full Potential ◽  
New Era

Abstract Background There is now rapidly growing global awareness of the potential of large-scale community health worker (CHW) programmes not only for improving population health but, even more importantly, for accelerating the achievement of universal health coverage and eliminating readily preventable child and maternal deaths. However, these programmes face many challenges that must be overcome in order for them to reach their full potential. Findings This editorial introduces a series of 11 articles that provide an overview highlighting a broad range of issues facing large-scale CHW programmes. The series addresses many of them: planning, coordination and partnerships; governance, financing, roles and tasks, training, supervision, incentives and remuneration; relationships with the health system and communities; and programme performance and its assessment. Above all, CHW programmes need stronger political and financial support, and this can occur only if the potential of these programmes is more broadly recognized. The authors of the papers in this series believe that these challenges can and will be overcome—but not overnight. For this reason, the series bears the title “Community Health Workers at the Dawn of a New Era”. The scientific evidence regarding the ability of CHWs to improve population health is incontrovertible, and the favourable experience with these programmes at scale when they are properly designed, implemented, and supported is compelling. CHW programmes were once seen as a second-class solution to a temporary problem, meaning that once the burden of disease from maternal and child conditions and from communicable diseases in low-income countries had been appropriately reduced, there would be no further need for CHWs. That perspective no longer holds. CHW programmes are now seen as an essential component of a high-performing healthcare system even in developed countries. Their use is growing rapidly in the United States, for instance. And CHWs are also now recognized as having a critically important role in the control of noncommunicable diseases as well as in the response to pandemics of today and tomorrow in all low-, middle-, and high-income countries throughout the world. Conclusion The promise of CHW programmes is too great not to provide them with the support they need to achieve their full potential. This series helps to point the way for how this support can be provided.

Promotoras Voice Their Challenges in Fulfilling Their Role as Community Health Workers

2020 ◽  
pp. 152483992092118
Author(s):  
Pamela Orpinas ◽  
Rebecca A. Matthew ◽  
Luis R. Alvarez-Hernandez ◽  
Alejandra Calva ◽  
J. Maria Bermúdez
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Participatory Research ◽  
English Language ◽  
Health Workers ◽  
Cultural Beliefs ◽  
Community Based Participatory Research ◽  
Well Being ◽  
Emotional Impact ◽  
Community Based

Promotoras de salud (Spanish for female community health workers) are integral to efforts to enhance the health and well-being of Latinx individuals, families, and communities. The purpose of this study was to describe the challenges that promotoras face and the proposed solutions from the perspective of the promotoras themselves. Five promotoras who worked for a year as volunteers in a community-based participatory research study, Lazos Hispanos, participated in two group interviews. Eight challenges emerged—balancing their new work with their family commitments, handling their perceived imbalance of power with men, managing the emotional impact of hearing participants’ problems, facing and handling the barriers imposed by having limited English language skills, feeling discouraged by the perception of ethnocentric beliefs and discrimination from some providers, feeling disheartened by the cultural beliefs of some Latinx participants, handling the lack of transportation for themselves and for the participants, and managing the burden of data collection for the research aspect of the program. The explanation of these challenges and the practical solutions they proposed are embedded in their intersecting identities. The solutions are a valuable addition to the practice of health promotion and community-based participatory research, particularly within Latinx communities.

scholarly journals Being a Community Health Worker Means Advocating

2019 ◽  
Vol 26 (2) ◽  
pp. 9-18
Author(s):  
Ryan I. Logan
Keyword(s):  
United States ◽  
Health Disparities ◽  
Community Health ◽  
Health Worker ◽  
Social Determinants ◽  
Health Workers ◽  
Well Being ◽  
The United States ◽  
The Social ◽  
New Framework

Community health workers (CHWs) participate in advocacy as a crucial means to empower clients in overcoming health disparities and to improve the health and social well-being of their communities. Building on previous studies, this article proposes a new framework for conceptualising CHW advocacy, depending on the intended impact level of CHW advocacy. CHWs participate in three ‘levels’ of advocacy, the micro, the macro, and the professional. This article also details the challenges they face at each level. As steps are taken to institutionalise these workers throughout the United States and abroad, there is a danger that their participation in advocacy will diminish. As advocacy serves as a primary conduit through which to empower clients, enshrining this role in steps to integrate these workers is essential. Finally, this article provides justification for the impacts of CHWs in addressing the social determinants of health and in helping their communities strive towards health equity.

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