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RHEY News & Tools:
Reaching Out with Community
Health Workers
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Dear Colleagues:
In communities across the U.S., an estimated 120,000 or more[1] women and men serve in neighborhoods, schools, homes, faith- and community-based organizations, clinics, and other community spaces, bridging the gap between individuals and communities and the health services they need. These community health workers (CHWs), who typically share the culture of the populations they serve, are also known by other titles including "promotores," patient navigators, and outreach workers.
This issue of RHEY News & Tools provides background information, resources, and tools to assist you in considering how CHWs - adults and teens, female and male - can build community capacity to address teen pregnancy in your program service area. While results of CHW interventions for teen pregnancy prevention are not yet documented in the peer-reviewed literature, relevant and persuasive examples exist, and some are highlighted here.
According to one of many definitions, community health workers are "frontline public health workers who are trusted members of and/or have an unusually close understanding of the community served." [2] A common thread in each definition is their role as connectors, advocates, messengers, and providers of culturally and linguistically appropriate education, information, outreach, and referrals for vulnerable and underserved populations in their communities.
CHWs' effectiveness in improving prevention, control, and access to care for conditions including HIV/AIDS, diabetes, cancer, and heart disease, is well documented. A number of states now have programs to expand their roles and strengthen financial support. Nationally, the Affordable Care Act of 2010 includes provisions relevant to CHWs that are to become effective during the next four years.
As you think through strategies guided by best practice for working in your diverse communities, consider the vital role that community health workers can play in successfully implementing each of those strategies - mobilizing, educating, and engaging adults and youth in communities to reduce disparities and inequities in teen births.
In the spirit of collaboration,
Myriam Hernandez Jennings
JSI Research & Training Institute, Inc.
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Featured Tool
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A Guide to Promotora Programs
Planned Parenthood Federation of America, Inc., 2004
This guide describes different promotora program models, offers guidelines for implementing and evaluating promotora programs, and provides examples of promotora programs in operation across the nation. Use it to help determine whether a promotora program is right for your organization and community, and to help plan and develop an effective promotora program.
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Community Health Workers in Action
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Training of adults as peer educators is one component of Plain Talk's neighborhood-based interventions to reduce teen pregnancy. The real stories and lessons learned from the launching of this initiative in 5 distinctly different communities illustrate that engaging and training community residents to deliver outreach and education to adults and teens can bring about real and positive change.
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"In the hallways, on the streets and in the courtyards, the people...are talking about sex, protection, family responsibility, taking care of yourself, future options and about the
importance of school."
Plain Talk (p 29)
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Promotoras de la Salud
Our Bodies Ourselves, April 30th, 2010
This article highlights a successful Promotoras (CHWs) Program in Springfield, MA which has been providing important sexual health education to the community in group and individual settings to raise awareness and increase access to sexual health information and services.
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IN THIS ISSUE
Featured Tool Community Health Workers in Action
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Featured Website
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Rural Assistance Center, Health and Human Services Information for Rural America
This website provides tools to help you evaluate opportunities for developing a CHW program and develop a program for your area, including resources and best practices developed by successful programs. Each of eight modules concentrates on different aspects of CHW programs.
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Also of
Interest
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Community Health Workers: What Do We Know About Them?
World Health Organization, January 2007
This review of existing evidence on the feasibility and effectiveness of CHW programs worldwide assesses the many facets of CHW programs and provides
recommendations for fully tapping the potential of this important health resource.
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U.S. Department of Health and Human Services Administration, Bureau of Health Professions
This report is a comprehensive information resource about CHWs, resulting from a HRSA-funded national study of the CHW workforce that was conducted between 2004 and 2007.
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Community Health Workers: Part of the Solution
Rosenthal et. al. Health Affairs, Vol. 29, No. 7, 1338-1342 (2010).
The authors' recommendations and principles for developing the workforce of CHWs are backed by brief and informative discussion of CHWs' roles, responsibilities, and contributions. Case studies from two states illustrate how CHWs can be supported and sustained by changes in systems and policies.
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Community Health Workers: Closing Gaps in Families' Health Resources
Family Strengthening Policy Center, National Human Services Assembly, March 2006.
This overview of CHWs from the perspective of low-income families' needs highlights the important role of CHWs in reaching vulnerable and underserved families. It reviews the challenges and opportunities for ensuring their place as a sustainable and effective component of health and human service delivery and includes helpful tables and resource lists.
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"Community health workers develop peer-to-peer relationships of trust with patients, rather than provider-client relationships. It is these relationships...that contribute most importantly to the workers' ability to communicate openly with patients...and ultimately to improve health care access and outcomes."
Health Affairs, 29, no.7 (2010):1338-1342, Community Health Workers: Part Of The Solution. E. Lee Rosenthal et. al.
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[1] Rosenthal E, Brownstein J, Rush C, Hirsch G, Willaert A, Scott J, Holderby L, Fox, D. Community Health Workers: Part of the Solution ( http://content.healthaffairs.org/content/29/7/1338.full.pdf+html ). Health Affairs, Vol. 29, No. 7, 1338-1342 (2010). doi: 10.1377/hlthaff.2010.0081 Health Aff Jul
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 JSI Research & Training Institute, Inc. We welcome your feedback at RHEY@jsi.com
Many thanks to our reviewers and advisors:
Marta E. Flores, Family Health Centers of San Diego;
Jessica Aguilera, The Prevention and Access to Care and Treatment (PACT) Program;
Gretchen Latowsky, JSI Research & Training Institute, Inc.
RHEY News & Tools is published by JSI Research & Training Institute's Working with Diverse Communities Component, part of the Teenage Pregnancy Prevention: Integrating Services, Programs, and Strategies Through Community-wide Initiatives project, funded by the Office of the Assistant Secretary of Health (OASH), Office of Adolescent Health (OAH)/Centers for Disease Control and Prevention (CDC) under the President's Teen Pregnancy Prevention Initiative (TPPI).
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