The Transcultural Community Health Initiative Community Health Workers

The Transcultural Community Health Initiative: Community Health Workers Bridging the Gap RIH Community Service Committee Update 03 November 2005 Dannie Ritchie MD, MPH Center for the Study of Race and Ethnicity in America Brown University

(Social Determinants of Health Disparities – not in this excerpt) Community Health Workers

Community Health Workers And Community Health Worker Survey Spring 2005

Community Health Worker Definition § A frontline public health worker who serves as a link to resources which promote the health and well being of individuals and communities, and facilitates access to service providers by applying his or her unique understanding of the experiences, language and culture of the community he or she services, carrying out at least one of the seven core roles: § Bridging between communities and health and social service systems (two-way cultural mediation); § Providing culturally appropriate health education and information; § Assuring people get services they need; § Providing informal counseling and social support; § Advocating for individual and community needs; § Providing direct service, such as basic first aid and administering health screening tests; and § Building individual and community capacity.

Survey Results n CHW Inclusion Criteria n Response Rate n Educational Requirements n Training Requirements n Formal Curriculum n Qualities looked for n Numbers Organization Served n Volunteer or Salaried

CHW Inclusion Criteria n Share common experience, language, or culture with the communities they serve n Promote healthy living through education n Help community residents understand gain access to formal health and human service systems n Coordinate client interaction with services

Response Rate n Of 62 agencies 52 responded - rate 83. 8% n 42 completed the survey n 38 of the respondents qualified n 10 were responsive but did not complete their survey n 10 either were non-responsive or had missing contact information.

Educational Requirements

Number Population Served

Volunteer or Salaried Staff

TCHI Design Model Community Health Worker Program to foster Community-driven interventions

Process – Progress CHW Core Competencies/Skills n communication skills n interpersonal skills n knowledge base n capacity-building skills n advocacy skills n teaching skills n organizational skills

Process – Progress TCHI PROGRAM TRAINING OVERVIEW n Session 1: Intro to CHW Training Session 2: Communication Session 3: Teaching Others Session 4: Leadership & Facilitation Session 5: Comm. Health Promotion & Capacity Building I Session 6 : “ “ “ II Session 7: “ “ “ III Session 8: Self-care Skills Session 9: CPR & First Aid Session 10: Working With Individuals & Families I Session 11: “ “ II Session 12: Graduation

Social Value Context Decrease Health Disparities thru effects on Social Determinants of Health by: n Building community capacity – Building a diverse health workforce – Creating job training and employment for adult workforce – Increasing literacy and Health literacy – Providing a link for engagement/participation

CHWs: RI and National context n The initiative works on many levels: – It improves existing networks for educational options – It creates opportunities in a new labor force – It promotes community organizations advocacy, and health literacy

Social Infrastructure Context CHWs Bridging the Gap n By applying his or her unique understanding of the experiences, language and culture of the communities he or she serves, CHWs can: – Be a wraparound service that overcomes logistical and cultural barriers to care – Contribute to Continuity of Care – Be the voice of the community and part of the community integration in the health care team

Direct services CHWs Bridging the Gap n Create resource data bank n Outreach services (i. e. health education, health promotion, B. P. screening, motivate people to seek care, take people to services, make referrals) n Link to social service (i. e. assistance with social service applications) n Informal counseling and social support (i. e. leading social support groups)

Current Plan

Current Plan n Refinement of CHW Core Curriculum n Training of the Trainer and preparation of the Participant manual n CHW’s Recruited n CHW Curriculum Program Implemented