who are chws? · 2. interpersonal and relationship-building 3. service coordination and navigation...
TRANSCRIPT
Durrell FoxCHW, Health Equity Consultant JSI Research & Training InstituteBoston, MA & Providence, RI Offices
Presentation outline
▪ 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:
Durrell J. Fox
Disclosed no conflict of interest.
Who are CHWs?CHWs are the bridge to a healthy community
Who are CHWs?
• 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
Who are CHWs?
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
Example of a poster that describes the role of a Community Health Worker in a clinical setting.
CHW Core Roles, Skills and Qualities
Supporting Communities CHWs Supporting Communities
Core Roles1. 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. Communication2. Interpersonal and relationship-building3. Service coordination and navigation4. Capacity building5. Advocacy 6. Education and facilitation7. Individual and community assessment8. Outreach9. Evaluation and research 10.Knowledge Base
Qualities
Bridging Community and Care Systemswith CHWs
Bridging Community & Care Systems
Community Based Organizations
(CBOs)
CHWs
Clinical Care
CommunityPrevention
Person Centered “Upstream Medicine”
Monitor Clinical Impacts
Refer to Community
Services
Assess Patient Needs
Clinical-Community linkages to address
Social Determinants of Health
Populations Served
▪ 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
Common Activities & Strategies
▪ Outreach▪ Health education▪ Health care system navigation▪ Chronic disease self-management
support
▪ Support for medication adherence▪ Insurance Enrollment
▪ Client advocacy
Addressing the SocialDeterminants of Healthwith CHWs
Social Determinants of Health
http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=39
Access
▪ 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
Achieving Health Equity
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
▪ 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)
CHWs Improving Healthcare Quality
▪ 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 FoxJSI Research & Training Institute617 [email protected]