What is a Community Health Worker?
Community Health Workers (CHWs) are members of the community who improve access to healthcare and eliminate healthcare disparities in multi-ethnic communities. In addition, CHWs build trusting relationships with the communities they serve through education, advocacy, and outreach.
CHWs accomplish this by:
- empowering communities with education and information about what services are available;
- helping people navigate through the systems and institutions that offer those services;
- linking and referring people to medical homes so that necessary coordination of services and primary care and prevention can be the focus of treatment;
- conducting policy research by identifying policies that prevent the underserved and uninsured access to health care and social services;
- providing policy recommendations to community leaders and policy makers on how to reduce the gaps in the health care system.
Through our Community Dialogues (Part 1, Part 2, Part 3) we have learned just how important the work of CHWs is and how necessary it is to recognize their work and to link it systematically to the integrated system of care. In 2002, CVM partnered with United Way of Miami-Dade to develop the Community Health Workers Project with the goal of integrating CHW practice and training with existing primary and preventive healthcare services and community resources and to ultimately develop a para-professional career track for CHWs.
The project has been designed in five consecutive phases: preliminary, research, planning, pilot, and implementation phases. The Planning Phase involved developing a local collaborative to create a training curriculum and manual based on the expertise of the community members and the research of the previous phase. Extensive reviews of various CHW training curriculums used nationally were carried out and recommendations were submitted to stakeholders for the development of Levels II and III. From this collaborative process a comprehensive three-level training manual geared for Miami-Dade County was developed. CVM piloted the basic Level I training course in the Summer of 2005 at Miami Dade College and evaluated the curriculum with the support of project stakeholders and six funders, including: The Children’s Trust, The Health Foundation of South Florida, Annie E. Casey Foundation, the W.K. Kellogg Foundation, Dade Community Foundation, the Women's Fund of Miami Dade County, and Alleghany Franciscan Ministries, Inc.
CHW Training Program
The success of the CHW model comes from global, indigenous, and grassroots efforts helping people access care. Standardized trainings that originate from the knowledge of CHWs who live in the communities they serve will help to streamline and bolster their existing work in the community. Community Voices Miami has been working since 2002 in partnership with CHWs and community leaders to develop a standardized training for CHWs. Our curriculum consists of 3 levels of study designed to provide our clients with a holistic model of care and a para-professional career track. Our level I training “Introduction to Community Health Workers” provides the basic foundation for CHWs and focuses on four core competencies: Confidentiality, Cultural Sensitivity, Advocacy and Empowerment. Level II training has four Modules. Module I is the Florida Family Development Credentialing (FFDC), Module II covers Essentials of Community Workers, Module III addresses Professional Development and Module IV includes Community Resources. Level III is also composed of 4 Modules. Module I includes Essentials of Community Workers, Module II covers Self –empowerment, Module III addresses Community Workers Skills and Module IV is the Practicum experience. Every Module addresses the 4 core competencies.
Some of the core elements of our training include:
- Characterizing the role of CHWs
- Legal, cultural, and confidentiality issues CHWs may face
- Recognizing warning signs and protective factors for families and neighborhoods
- Excellent interpersonal communication skills
- How to promote healthy lifestyles to our clients
- Skills used in outreach and health education
- Client advocacy skills
- Oral presentation, documentation, and interviewing skills
- Client assessment skills and team work
- Community resources available to them
- Practical experience through the Practicum
This approach not only benefits the community by improving access to care, but also by giving the CHWs the opportunity to be recognized and to continue on a professional career track. By certifying the work CHWs already are doing, we are working to ensure the recognition of these para-professionals as one of the essential components of the integrated system of health care, while encouraging efforts that keep our community healthy.
Another prime example of this approach is our collaborative partnership with the Little Havana Community Partnership (LHCP) to coordinate professional training development activities in the community. The LHCP Community Health Workers completed their Level I training at Miami Dade College in June 2007, and began their field experience with the guidance of the instructor, and the appropriate partnering agencies in July 2007. In addition to providing training, our goal in this collaborative also includes: (1) coordination of continuous professional development training through monthly CHW Network meetings and other trainings in the community at large; (2) guidance and leadership to assure their retention and integration into the communities system of care; and, (3) provision of feedback to our funders and collaboratives regarding CHWs’ integration into the health care delivery system.
TThe results from the Training Program Evaluation for Community Health Workers: Final Report indicated that the training participants and their supervisors were satisfied with the course, the curriculum was appropriate for Miami Dade County, and there was a statistical increase in trainee knowledge from pre- to post-training. Recommendations from the evaluation report, which included feedback from the trainee participants, provided the basis for editing the curriculum.
The Level I training is perfect for community members who want to begin their Community Health Worker careers. Through comprehensive reviews of various CHW training curriculums used nationally, recommendations were submitted to the stakeholders for the development of Levels II and III. CVM is currently building the curriculum with Miami Dade College and developing additional specialized classes as well as using existing Miami Dade College classes specific to Community Health Work.
As community support for the project continued to spread, we have been able to count on the support of the Annie E. Casey Foundation, Dade Community Foundation, Miami-Dade College and The Children’s Trust. Levels II and III target CHWs who are already working in the field but are looking to expand their knowledge and build their networks. The curriculum work is now in the final development phase for the implementation of the pilot of level II Module I in early 2008. CHWs that complete Level II, Module I will have 9 credit hours and Family Development Credentialing Certification (FDC). Simultaneously, we continue to develop the remaining Level II modules and the Level III training for implementation in the future. The CHW Project is currently engaged in a strong partnership with Miami Dade College to have the curriculum certified which will allow participants who complete the entire three levels of training to receive academic credit and a certification or an Associates of Science degree in Human Services with a specialization in Community Health Work.
The CHW Network
CVM has witnessed much excitement and growth in the last year in regards to the Community Health and Navigator Network. The network is comprised of Community Health Workers and Health Navigators. There are six medical partnerships represented and each of those partnerships represent over 20 community health centers, churches and clinics. The network serves as a place where CHWs and HNs receive professional development training on:
- Resources identification
- Leadership development
- Immigration
- Data collection
- Domestic violence
- Policy and Advocacy
Each meeting concentrates on a different topic and we are learning that CHWs are natural researchers when it comes to identifying health care access barriers for those most in need; they also inform policy by providing feedback to our funders and collaboratives on how to close existing gaps in the health care system. Related to this issue CHWs have created fact sheets (CHW Story #1, CHW Story #2, CHW Story #3, CHW Story #4) addressing the five year ban on KidCare which affects many of the families they are trying to access health care for.
The CHW and HN network meets on a monthly basis and plays an essential role in CHW retention and assisting the partnerships they work for to achieve their primary goal of connecting people to health care and social services.
TThe To share your ideas and obtain more information about Community Health Workers, please contact the Project Director, Joyce Nunez at: jnunez@collinscenter.org or 305 377-4484, ext.
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