Presentation outline Durrell Fox CHW, Health Equity Consultant JSI Research & Training Institute Boston, MA & Providence, RI Offices CHW titles (Umbrella) National CHW definition National CHW Core Roles, Skills and Qualities CHWs bridging community and clinical linkages CHWs addressing Social Determinants of Health (SDOH) and health equity Presenter Disclosure Information In compliance with the accrediting board policies, the American Diabetes Association requires the following disclosure to the participants: CHWs are the bridge to a healthy community Durrell J. Fox Disclosed no conflict of interest. promotor(a) de salud peer leader outreach educator community health advisor home visitor community health worker street outreach worker outreach advocate patient navigator peer advocate youth worker community coordinator family service coordinator community health representative The American Public Health Association defines a CHW as a frontline public health worker who: Is a trusted member of and/or has an unusually close understanding of the community served Serves as a link between health/social services and the community Facilitates access to services and improves the quality and cultural competence of service delivery Builds individual and community capacity by increasing health knowledge and self-sufficiency through outreach, community education, informal counseling, social support and advocacy
CHW Core Roles, Skills and Qualities Example of a poster that describes the role of a Community Health Worker in a clinical setting. Supporting Communities CHWs Supporting Communities Core Roles 1. Serve as cultural mediator among individuals, communities, and health and social service systems 2. Deliver culturally appropriate health education and information 3. Provide care coordination, case management, and system navigation 4. Offer coaching and social support 5. Advocate for individuals and communities Core Roles 6. Build individual and community capacity 7. Provide direct service 8. Implement individual and community assessments 9. Conduct outreach 10. Participate in evaluation and research
Examples of Roles and Sub-Roles CHW Core Skills 1. Communication 2. Interpersonal and relationship-building 3. Service coordination and navigation 4. Capacity building 5. Advocacy 6. Education and facilitation 7. Individual and community assessment 8. Outreach 9. Evaluation and research 10.Knowledge Base Qualities Bridging Community and Care Systems with CHWs Bridging Community & Care Systems Person Centered Upstream Medicine Community Based Organizations (CBOs) Assess Patient Needs Refer to Community Services Monitor Clinical Impacts Clinical Care CHWs Community Prevention Clinical-Community linkages to address Social Determinants of Health
Populations Served Common Activities & Strategies Persons living with or at risk for Diabetes Persons with substance use disorders Homeless persons Persons with disabilities Immigrants/refugees Older adults Pregnant women Migrant workers Outreach Health education Health care system navigation Chronic disease self-management support Support for medication adherence Insurance Enrollment Client advocacy Addressing the Social Determinants of Health with CHWs Social Determinants of Health http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=39 Access Achieving Health Equity Increase access to health insurance Increase access to and use of preventive education, screenings, and treatment services (Primary, secondary and tertiary prevention) Reduce unnecessary use of urgent care Increase use of primary care and medical homes Adherence support Address health disparities among: People at risk for and living with diabetes Low-income individuals Communities of color Linguistic minorities Immigrants, refugees Children, youth, elders Rural communities
CHW Impact Quality CHWs Improving Healthcare Quality Improving diabetes prevention and chronic disease management Improving outcomes of CBO and healthcare teams in areas of: Client and community assessment Community services and care coordination Primary and secondary prevention education Strengthening health literacy Strengthening culturally competent care and provider practices (organizational effectiveness) Patient engagement and satisfaction. Outcomes of integrated care teams including CHWs. Care coordination. Rx adherence. Care plan utilization. Patient self-management. Culturally competent/responsive provider practices. CHWs are unique CHWs are distinguishable from other health professionals because they: Are hired primarily for their understanding of the populations and communities they serve Conduct outreach a significant portion of their time Have experience providing services in and across community and clinical settings Growing Research Evidence & ROI CHWs can help significantly improve outcomes of patients and care teams Perform a variety of roles Help patients reduce risks of complications from chronic diseases Improve compliance with prescribed treatment plans Improve patient self-management Durrell Fox JSI Research & Training Institute 617 905-1003 durrell_fox@jsi.com