CHWs in the Community

Community health workers are utilized in a variety of capacities throughout the world to improve health outcomes for different populations. In areas where there are health professional shortages, CHWs have been effectively used to provide care extension for a variety of health professionals. For example, in areas where people with disabilities do not have access to rehabilitation therapists such as physical, occupational, and speech therapy, CHWs can participate in Community-Based Rehabilitation (CBR) programs to improve health outcomes for this underserved population.

Community-Based Rehabilitation was developed by the World Health Organization as an effort to improve the quality of life for people with disabilities. CBR programs take a multi-sector approach to addressing the social determinants of health for people with disabilities to improve access to the community, care, and overall quality of life. Successful CBR programs are implemented in partnership with people with disabilities, their families, the community, governmental, and non-governmental organizations, and social services including CHWs.

In Ohio, there is great opportunity for CHWs to become involved with working with people with disabilities and to extend care of rehabilitation professionals. As an example, there are CHWs in that are currently working with Help Me Grow organizations in Ohio which provide early intervention services to children birth to three years with developmental delays and developmental disabilities.

For those who are interested in learning more about Community-Based Rehabilitation and how to work with people with disabilities, here is a list of selected resources:

• World Health Organization Description of CBR |  Information Link
• World Health Organization CBR Guidelines |  Information Link
• World Health Organization CBR Matrix | Information Link
• Healthcare Access for People with Disabilities CE Courses | Course Link

With the nation’s deficit of primary care providers many hospitals and other care facilities are seeing the benefit of utilizing support staff like Community Health Workers (CHWs) to fill in the gaps.

Most hospitals and other care facilities utilize CHWs for:

•    Relationship development and more time one on one defining area’s of need
•    Assisting with some of the nonclinical tasks that have traditionally been carried out by nurses and/or physicians
•    Understanding the languages, cultures, and challenges of the populations they serve
•    Identifying social, cultural, and even economic issues of patients and connecting them with community resources
•    Helping patients identify needs like transportation to appointments, prescription access and fulfillment, and helping link them to resources for basic necessities like food and housing
•    Inter-professional team care and as a part of their patient centered models alongside residents

The presence of CHWs in healthcare facilities across the nation will continue to increase as more organizations share their positive outcomes and experiences.

Article Link

For details on return on investment (ROI), check out our additional Resource Materials section below.

Community health workers can also be found working in the home to help extend social work and other social services. For example, in different parts of the country, emergency medical technicians have been trained as CHWs (paramedicine) to help identify high utilizers of emergency medical services. These CHWs have visited patients in their home to help connect patients to appropriate social services and to address the social determinants of health to improve the overall health and well-being of patients.

If interested in learning more about how emergency medical technicians can work as CHWs in the home, see the Resource Materials section below.

Today many health and wellness classes are being taken out of the classroom. Consequently, students are not receiving pertinent lessons on well-being. To combat this, Northeast Ohio Medical University’s CHW program has decided to train inner-city Cleveland teachers as CHWs and have them incorporate health and wellness into their everyday lessons, while still teaching the required standards.

For example, a high school biology teacher was talking about bacteria. Within this lesson she taught her students the importance of handwashing and how to properly wash their hands. The next day she had several students coming to her reporting that they had washed their hands properly! Additionally, if a student approaches a teacher with a health question or other issue that a CHW could assist with, they can be a first line of defense.

Lessons taught included:

• Pedigrees — Discussion on heredity of heart disease
• Lead Testing and Implications — Discussion on Flint Michigan
• Mechanisms of Inheritance — Discussion on potential social, moral, and political issues of genetic mutation
• Antibiotic Resistance — Why some people are still sick after taking medications
• Communicable Disease — Discussion on different types of medication and bacteria vs. viruses (specifically that antibiotics don’t cure viral infections)
• Genetic Disease — Exploring relationship between mutations and genetic diseases, diagnoses, symptoms, prognosis, and treatments
• Skeletal System Function & Bone Health — Discussion on why bone health matters, how do you know if you have healthy bones, and what to do to keep bones healthy
• Inside the Cell City — Discussion on why each part of the cell is important
• The Economics of Early Home Pregnancy Tests — Analyzing brands of pregnancy tests, how to modify expensive pregnancy tests to make them cheaper without sacrificing accuracy, discuss other design propositions to develop a better design

Community health workers have been utilized in a variety of settings, which include prisons to improve the health and well-being of incarcerated individuals. For example, in Ohio, CHWs have worked with incarcerated individuals to obtain health insurance as well as to refer them to behavioral health and substance abuse treatment services when appropriate. In New Mexico, Project ECHO created the New Mexico Peer Education Project in which incarcerated individuals are trained by Project ECHO CHW staff to become peer educators to help reduce the incidence of hepatitis C in New Mexico prisons.

For more information regarding the New Mexico peer education project, visit Website.

Community Health Centers, or CHCs, are non-profit healthcare facilities that are designed to meet the needs of the communities in which they serve and are located. With 46 CHCs and over 250 locations just in Ohio, CHC’s collectively are the largest health care system in the nation.

CHCs are governed by a board which is made up of at least 51% of its community members and/or leaders which provides a strong focus on the needs of the populations they serve. If a CHC is a Federally Qualified Health Center, or FQHC, they are funded specifically to serve a population that is underserved, uninsured, and/or under insured.

Community Health Workers serve a big part when working in and for CHCs in that they can provide the hands on support to patients that they may not get in a normal healthcare environment. This individualized care is helping to increase the health outcomes of patients all across Ohio.

For more information and to find a Community Health Center near you, visit Website.