scholarly journals Recruitment, Training, and Roles of the Bilingual, Bicultural Navegantes: Developing a Specialized Workforce of Community Health Workers to Serve a Low-Income, Spanish-Speaking Population in Rhode Island

2021 ◽  
Vol 9 ◽  
Author(s):  
Meghan McCarthy ◽  
Katherine Barry ◽  
Cindy Estrada ◽  
Brenda Veliz ◽  
Damaris Rosales ◽  
...  

Clínica Esperanza/Hope Clinic (CEHC) employs Navegantes, who are specially-trained bilingual Community Health Workers (CHW), as key team members who improve the ability of the clinic to provide care for and improve the health status of a large population of uninsured Spanish-speaking patients in Providence, Rhode Island. Given the growing demand for CHWs at the clinic and in the broader healthcare sector in the state, CEHC developed the Advanced Navegante Training Program (ANTP). The ANTP prepares community members to become certified CHWs who are equipped to provide patient navigation and lifestyle coaching as well as professional medical interpretation services. The ANTP is developed and taught by CEHC Navegantes who themselves are bilingual and bicultural peers of trainees as well as the population that CEHC serves. Upon graduation, ANTP trainees have been able to attain higher-paying and fulfilling careers in a range of healthcare and other community settings. The ANTP offers a low-cost, community-based model for training CHWs who are uniquely prepared to promote health and well-being among medically underserved patients.

Author(s):  
Tyler Prentiss ◽  
John Zervos ◽  
Mohan Tanniru ◽  
Joseph Tan

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.


Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 367
Author(s):  
Pilar Charle-Cuéllar ◽  
Noemí López-Ejeda ◽  
Mamadou Traore ◽  
Adama Balla Coulibaly ◽  
Aly Landouré ◽  
...  

(1) Background: The Ministry of Health in Mali included the treatment of severe acute malnutrition (SAM) into the package of activities of the integrated community case management (iCCM). This paper evaluates the most effective model of supervision for treating SAM using community health workers (CHWs). Methods (2): This study was a prospective non-randomized community intervention trial with two intervention groups and one control group with different levels of supervision. It was conducted in three districts in rural areas of the Kayes Region. In the high supervision group, CHWs received supportive supervision for the iCCM package and nutrition-specific supervision. In the light supervision group, CHWs received supportive supervision based on the iCCM package. The control group had no specific supervision. (3) Results: A total of 6112 children aged 6–59 months with SAM without medical complications were included in the study. The proportion of cured children was 81.4% in those treated by CHWs in the high supervision group, 86.2% in the light supervision group, and 66.9% in the control group. Children treated by the CHWs who received some supervision had better outcomes than those treated by unsupervised CHWs (p < 0.001). There was no difference between areas with light and high supervision, although those with high supervision performed better in most of the tasks analyzed. (4) Conclusions: Public policies in low-income countries should be adapted, and their model of supervision of CHWs for SAM treatment in the community should be evaluated.


BMJ Open ◽  
2018 ◽  
Vol 8 (4) ◽  
pp. e021467 ◽  
Author(s):  
James O’Donovan ◽  
Charles O’Donovan ◽  
Isla Kuhn ◽  
Sonia Ehrlich Sachs ◽  
Niall Winters

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1359-1359
Author(s):  
Gargi Wable Grandner ◽  
Katherine Dickin ◽  
Purnima Menon ◽  
Tiffany Yeh ◽  
John Hoddinott

Abstract Objectives Efforts to integrate nutrition into antenatal health promotion in low income countries have led to increased involvement of community health workers (CHWs) in counseling on maternal nutrition. Little is known about how CHWs “package” messages in resource-poor communities to increase adoption of recommended maternal nutrition behaviors. We developed focused ethnographic techniques to explore this. Methods We interviewed 35 randomly selected CHWs providing monthly counseling to pregnant women and their families in 7 ‘Alive & Thrive’ intervention sites in Bangladesh. Two sorting exercises explored CHW strategies for promoting and perceptions of adoption of messages on micronutrient supplements, maternal dietary adequacy, and rest during pregnancy. In-depth probing on messages identified as “difficult” to deliver or adopt revealed how CHWs addressed barriers. Analysis of quantitative sorting data complemented thematic coding of qualitative textual data using grounded theory. Results CHW communication strategies involved 3 themes: feasibility (attitudes, norms, agency, poverty), audience (influence, motivators, support), and linguistic choice (emotional appeals, metaphors, logic, sellable but inaccurate arguments). CHWs viewed micronutrient messages as least difficult to adopt, requiring minimal “packaging”. Dietary messages were moderately difficult to adopt, prompting CHWs to leverage cultural congruence to target family members with different strategies. For example, messaging on diet diversity targeted husbands—the primary food-buyers—with logical arguments highlighting costs of inaction. When mothers-in-law held beliefs restricting gestational food intake, CHWs used metaphors (‘healthy tree, healthy fruit’) or faith-based appeals. Some CHWs used inaccurate messages (‘mother rests, baby rests’) to promote rest during pregnancy because it was seen as the least feasible behavior to adopt. Conclusions Where behavior change is viewed as feasible, CHWs use culturally resonant strategies to enhance adoption of maternal nutrition behaviors. Cultural congruence, or shared beliefs, language and cultural identity, is key to CHW effectiveness, but unhelpful for contextually infeasible behaviors. BCC programs co-designed with CHWs could improve messaging and effectiveness. Funding Sources Cornell AWARE Travel Grant.


2020 ◽  
Vol 82 ◽  
pp. 102944 ◽  
Author(s):  
Alessandro Jatobá ◽  
Hugo Cesar Bellas ◽  
Bárbara Bulhões ◽  
Isabella Koster ◽  
Rodrigo Arcuri ◽  
...  

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Rhonda C. Boyd ◽  
Marjie Mogul ◽  
Deena Newman ◽  
James C. Coyne

Postpartum depression is a serious and common psychiatric illness. Mothers living in poverty are more likely to be depressed and have greater barriers to accessing treatment than the general population. Mental health utilization is particularly limited for women with postpartum depression and low-income, minority women. As part of an academic-community partnership, focus groups were utilized to examine staff practices, barriers, and facilitators in mental health referrals for women with depression within a community nonprofit agency serving low-income pregnant and postpartum women. The focus groups were analyzed through content analyses and NVIVO-8. Three focus groups with 16 community health workers were conducted. Six themes were identified: (1) screening and referral, (2) facilitators to referral, (3) barriers to referral, (4) culture and language, (5) life events, and (6) support. The study identified several barriers and facilitators for referring postpartum women with depression to mental health services.


Aquichan ◽  
2020 ◽  
Vol 20 (2) ◽  
pp. 1-11
Author(s):  
Renata Francielle Melo dos Reis Fonseca ◽  
Silvia Matumoto ◽  
Joab Jefferson da Silva Xavier ◽  
Jossiane Wilke Faller

Objective: To identify the risk behaviors of the elderly at home, described by community health workers, and related factors. Materials and methods: Qualitative research, in the dialectical perspective, carried out through a focus group with community health workers from a family health strategy unit in a municipality of the State of São Paulo, Brazil. Thematic content analysis was used for the study. Results: The revealed risk behaviors are related to extrinsic factors (architecture, furniture, and equipment), socioeconomic factors (low income, level of education, deficit of social and a family support), and psychological factors (feeling of vulnerability, dependence and not self-acknowledging in a dangerous condition). Conclusions: Falls are the result of a complex interaction between the factors and, the behaviors studied so that adequate identification of these can subsidize individual and collective intervention actions, as well as care management and planning processes aimed at the health of the elderly person.


2021 ◽  
Vol 19 (S3) ◽  
Author(s):  
Joseph M. Zulu ◽  
Henry B. Perry

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.


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