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 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 ◽  
...  
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Rhode Island ◽  
Low Income ◽  
Health Workers ◽  
Low Cost ◽  
Large Population ◽  
Well Being ◽  
Healthcare Sector ◽  
Spanish Speaking

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.

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.

scholarly journals Effectiveness of service models and organisational structures supporting tuberculosis identification and management in hard-to-reach populations in countries of low and medium tuberculosis incidence: a systematic review

BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e019642 ◽  
Author(s):  
Charlotte C Heuvelings ◽  
Patrick F Greve ◽  
Sophia G de Vries ◽  
Benjamin Jelle Visser ◽  
Sabine Bélard ◽  
...  
Keyword(s):  
Systematic Review ◽  
European Union ◽  
Cost Effectiveness ◽  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Cost Effective ◽  
Service Models ◽  
Hard To Reach Populations ◽  
Organisational Structures

ObjectiveTo determine which service models and organisational structures are effective and cost-effective for delivering tuberculosis (TB) services to hard-to-reach populations.DesignEmbase and MEDLINE (1990–2017) were searched in order to update and extend the 2011 systematic review commissioned by National Institute for Health and Care Excellence (NICE), discussing interventions targeting service models and organisational structures for the identification and management of TB in hard-to-reach populations. The NICE and Cochrane Collaboration standards were followed.SettingEuropean Union, European Economic Area, European Union candidate countries and Organisation for Economic Co-operation and Development countries.ParticipantsHard-to-reach populations, including migrants, homeless people, drug users, prisoners, sex workers, people living with HIV and children within vulnerable and hard-to-reach populations.Primary and secondary outcome measuresEffectiveness and cost-effectiveness of the interventions.ResultsFrom the 19 720 citations found, five new studies were identified, in addition to the six discussed in the NICE review. Community health workers from the same migrant community, street teams and peers improved TB screening uptake by providing health education, promoting TB screening and organising contact tracing. Mobile TB clinics, specialised TB clinics and improved cooperation between healthcare services can be effective at identifying and treating active TB cases and are likely to be cost-effective. No difference in treatment outcome was detected when directly observed therapy was delivered at a health clinic or at a convenient location in the community.ConclusionsAlthough evidence is limited due to the lack of high-quality studies, interventions using peers and community health workers, mobile TB services, specialised TB clinics and improved cooperation between health services can be effective to control TB in hard-to-reach populations. Future studies should evaluate the (cost-)effectiveness of interventions on TB identification and management in hard-to-reach populations and countries should be urged to publish the outcomes of their TB control systems.PROSPERO registration numberCRD42015017865.

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.

Enhancing the Utility of Community Health Workers in Disaster Preparedness, Resiliency, and Recovery

2014 ◽  
Vol 2014 (1) ◽  
pp. 170-183
Author(s):  
Keith Nicholls ◽  
J. Steven Picou ◽  
Janel Lowman
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Oil Spill ◽  
Disaster Preparedness ◽  
Health Workers ◽  
Underserved Populations ◽  
Essential Elements ◽  
Educational Outreach ◽  
Oil Spill Response ◽  
Response And Recovery

ABSTRACT As part of the Deepwater Horizon Medical Settlement, the University of South Alabama's Coastal Resource & Resiliency Center is charged with preparing Community Health Workers (CHWs) to serve in areas affected by the oil spill. The immediate objective of this effort is to enhance primary and behavioral healthcare capacity and health literacy, especially among disadvantaged and underserved populations. A review of previous research confirms the utility of CHWs in accomplishing this objective. Findings further suggest that CHWs could play a crucial role in the area of oil spill response and recovery, but fulfilling this role will require appropriate training. In this paper, we provide an outline of CHW training that includes: 1) educational outreach to enhance literacy and promote preparedness; 2) identification and management of diseases and conditions associated with or exacerbated by such technological disasters; and 3) essential elements in the recognition and referral of psychosocial problems associated with the oil spill experience. Community Health Workers have great potential to contribute in the area of oil spill response and recovery by motivating maximum preparedness, speeding recovery, and increasing resiliency for future spills. It is important that institutional actors involved in the area recognize this potential and contribute to its realization.

scholarly journals Community health workers for pandemic response: a rapid evidence synthesis

2020 ◽  
Vol 5 (6) ◽  
pp. e002769 ◽  
Author(s):  
Soumyadeep Bhaumik ◽  
Sandeep Moola ◽  
Jyoti Tyagi ◽  
Devaki Nambiar ◽  
Misimi Kakoti
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Evidence Synthesis ◽  
Critical Role ◽  
Well Being ◽  
Contact Tracing ◽  
Housing Allowance ◽  
Role Clarity ◽  
Pandemic Response

IntroductionCoronavirus disease (COVID-19), affects 213 countries or territories globally. We received a request from National Health Systems Resource Centre, a public agency in India, to conduct rapid evidence synthesis (RES) on community health workers (CHWs) for COVID-19 prevention and control in 3 days.MethodsWe searched PubMed, websites of ministries (n=3), public agencies (n=6), multilateral institutions (n=3), COVID-19 resource aggregators (n=5) and preprints (n=1) (without language restrictions) for articles on CHWs in pandemics. Two reviewers screened the records independently with a third reviewer resolving disagreements. One reviewer extracted data with another reviewer cross-checking it. A framework on CHW performance in primary healthcare not specific to pandemic was used to guide data extraction and narrative analysis.ResultsWe retrieved 211 records and finally included 36 articles. Most of the evidence was from low-and middle-income countries with well-established CHW programmes. Evidence from CHW programmes initiated during pandemics and for CHW involvement in pandemic response in high-income countries was scant. CHW roles and tasks change substantially during pandemics. Clear guidance, training for changed roles and definition of what constitutes essential activities (ie, those that must to be sustained) is required. Most common additional activities during pandemics were community awareness, engagement and sensitisation (including for countering stigma) and contact tracing. CHWs were reported to be involved in all aspects of contact tracing - this was reported to affect routine service delivery. CHWs have often been stigmatised or been socially ostracised during pandemics. Providing PPE, housing allowance, equal training opportunities, transportation allowance, improving salaries (paid on time and for a broad range of services) and awards in high-profile public events contributed to better recruitment and retention. We also created inventories of resources with guiding notes on guidelines for health workers (n=24), self-isolation in the community (n=10) and information, education and counselling materials on COVID-19 (n=16).ConclusionsCHWs play a critical role in pandemics. It is important to ensure role clarity, training, supportive supervision, as well as their work satisfaction, health and well-being. More implementation research on CHWs in pandemics is required.

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.

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