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

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

Response Rate Of 62 agencies 52 responded - rate 83.8% Of 62 agencies 52 responded - rate 83.8% 42 completed the survey 42 completed the survey 38 of the respondents qualified 38 of the respondents qualified 10 were responsive but did not complete their survey 10 were responsive but did not complete their survey 10 either were non-responsive or had missing contact information. 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 communication skills communication skills interpersonal skills interpersonal skills knowledge base knowledge base capacity-building skills capacity-building skills advocacy skills advocacy skills teaching skills teaching skills organizational skills organizational skills

Process – Progress TCHI PROGRAM TRAINING OVERVIEW Session 1: Intro to CHW Training Session 2: Communication Session 3: Teaching Others 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 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 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: Building community capacity 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 The initiative works on many levels: 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 By applying his or her unique understanding of the experiences, language and culture of the communities he or she serves, CHWs can: 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 Create resource data bank Create resource data bank Outreach services (i.e. health education, health promotion, B.P. screening, motivate people to seek care, take people to services, make referrals) Outreach services (i.e. health education, health promotion, B.P. screening, motivate people to seek care, take people to services, make referrals) Link to social service (i.e. assistance with social service applications) Link to social service (i.e. assistance with social service applications) Informal counseling and social support (i.e. leading social support groups) Informal counseling and social support (i.e. leading social support groups)

Current Plan

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