Community Health Workers: Providing Essential Services in Rural America

Rural Health Research CenterNOR

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WALSH CENTERFOR RURAL HEALTH ANALYSIS

Community Health Workers: Providing Essential Services in Rural America

Rural Health Network Development Grant Program Grantee Meeting

Alana Knudson, PhDAugust 2, 2010 ~ Washington, DC


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Applying Evidence-Based Models in Rural Communities

Community Health Workers


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Focus on Community Health Workers

• Focus of the first module is on CHWs

• Why HRSA is interested in CHWs

• Context from the literature– No definition of CHWs– Little information available in

terms of models/best practices/resources


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Operational Definition of CHW

• Lay members of communities, paid or volunteer, who work in association with the local health care system;

• Usually share ethnicity, language, socioeconomic status, and life experiences with the community members served;

• May provide: interpretation & translation; health education & information; assistance in receiving needed care; informal counseling & guidance; advocating for health needs; and direct services, i.e., first aid, BP screening.

Community Health Workers National Workforce Study. March 2007. bhpr.hrsa.gov/healthworkforce/chw/3.htm


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Other Names for CHWs

• Community health advisors• Lay health advocates• Promotores(as) de Salud • Outreach educators• Community health representatives• Peer health promoters• Peer health educators


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Models of Care Using CHWs

• Member of care delivery team– Provides case management with lead provider– Responsible for coordination of care

• Navigator– Assists individual in navigating health care system, services, &

providers• Screening and Health Education Provider

– Works with individuals with specific health conditions, i.e., asthma and diabetes

– Accesses hard-to-reach populations & provides screenings, care methods


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Models of Care cont’d

• Outreach/enrolling/informing agent– “Outreach worker”– Reaches individuals eligible for benefits and enrolls

them or brings them to a health care provider

• Organizer– Promote community action around a specific

topic/issue– More commonly volunteers than paid workers


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Opportunities

• Extends access• Expands networks• Supports partnerships• Enhances credibility of

community organizations• Increases educational

opportunities for participants

• Provides applicable skills


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Challenges

• Payment issues– Difficult to determine payment amount– Part-time staff

• Evaluation– Impact

• Sustainability– Funding– Reimbursemenet


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Building the CHW Toolkit

CHW Toolkit Objectives: Organize available resources online Use Q&A format to seed thinking Be useful to grantees and other rural communities at different

levels of knowledge/stages of implementation of CHW programs

Provide resources that can help grantees, future applicants, and rural communities, more generally, to identify and apply relevant CHW evidence-based models to their projects


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How will the CHW toolbox be used?Learning: Who are CHWs and

what are their roles?

Hiring: What do we need to think about when hiring CHWs?

Modeling: Are there model CHW programs that may offer best practices?

Training: What types of training materials and approaches are available?

Adapting: How do we create a program that meets the needs of our community?

Evaluating: What benefits are weseeing, and what’s the next step?

Measuring: How do we measure the value of our CHW program?

Implementing: What resources will we need to implement a CHW program?

Sustaining: What do we plan for sustainability of our CHW program?

Funding: What resources are available for implementing CHW programs?

Disseminating: How do we disseminate our best practices to other communities?


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Organization of Modules

Module 1: Introduction to Community Health Workers Module 2: Model CHW Programs Module 3: Training Approaches for CHWs Module 4: Implementation of CHW Programs Module 5: Funding and Sustainability Module 7: Measuring and Evaluating the Impact of CHW Programs Module 8: Dissemination of CHW Resources and Best Practices


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1 - Introduction to CHWs (Example)

Questions Who are CHWs? Is there a standard definition of

CHWs? What are the roles of CHWs? What are the advantages of

including CHWs in my intervention?

Key Resources Resources on role of CHWs Research on CHW interventions Links to websites that focus on

CHWs Links to federal websites Glossary of definitions/terms Leadership speeches/ testimony Press releases

Objective: To introduce grantees, future applicants, and rural communities to CHWs and their roles.


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Questions for Discussion


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Contact InformationAlana Knudson, PhDCo-Director, Walsh Center for Rural Health [email protected]

Michael Meit, MA, MPHCo-Director, Walsh Center for Rural Health [email protected]

Ira Moscovice, PhD Mayo Professor and Division Head of the Division of Health Policy and Management at

the University of [email protected]

Documents

Community Health Workers: Providing Essential Services in Rural America