Medicine and Health Sciences Commons^™

An Expanded Chronic Care Management Approach To Multiple Chronic Conditions In Hispanics Using Community Health Workers As Community Extenders In The Rio Grande Valley Of Texas, Juliana Z Lopez, Minjae Lee, Soo K Park, Maria E Zolezzi, Lisa A Mitchell-Bennett, Paul G Yeh, Lubeth Perez, Natalia I Heredia, David D Mcpherson, Joseph B Mccormick, Belinda M Reininger

Journal Articles

INTRODUCTION: The synergistic negative effects of type 2 diabetes (T2DM) and hypertension increases all-cause mortality and the medical complexity of management, which disproportionately impact Hispanics who face barriers to healthcare access. The Salud y Vida intervention was delivered to Hispanic adults living along the Texas-Mexico Border with comorbid poorly controlled T2DM and hypertension. The Salud y Vida multicomponent intervention incorporated community health workers (CHWs) into an expanded chronic care management model to deliver home-based follow-up visits and provided community-based diabetes self-management education.

METHODS: We conducted multivariable longitudinal analysis to examine the longitudinal intervention effect on reducing systolic and diastolic blood …

The Power Of Promotores: Enhancing The Ability Of Medical Students To Provide For And Communicate With Underserved Populations, Jesse Allen, Suzette Jimenez, Ricardo Belmares, Jose Manuel De La Rosa, Nathan A. Holland, Jessica Chacon

School of Medicine Publications and Presentations

To increase community health knowledge, the El Paso Health Education and Awareness Team (EP-HEAT) was established at Paul L. Foster School of Medicine. The Medical Student Run Clinic (MSRC) emphasizes community health care access. Promotores de salud (community health workers) increase health care awareness and connect predominantly underserved communities with resources. Surveys were conducted to determine how EP-HEAT and MSRC patients’ communication with promotores affected their access to health care and communication skills. Surveys demonstrated that 91% of EP-HEAT members agreed that working with promotores improved their communication ability. All MSRC patients surveyed stated interacting with promotores helped improve health …

Barriers To Adherence To Standard Precautions Among Community Health Workers: A Scoping Review, Margaret D. Adejumo, Melanie Baker, Davina Porock

Research outputs 2022 to 2026

Aim: This review aims to map available evidence on the adherence level and barriers to standard precautions among home-based community health workers. Methods: A scoping review using the JBI protocol searched multiple databases (Medline, CINAHL, PsycINFO and Web of Science) as well as Google Scholar for published articles on standard precaution practices of community health workers during home visits. Search terms included “standard precautions”, “guideline adherence”, “community health” and “home care”. Two-stage screening (title/abstract and full-text) was conducted to select relevant articles. Results: Eight eligible studies yielded three major themes: home environment context, individual factors and organisational factors. Findings indicated …

Community Health Worker Certification Program - Motivational Interview, Advocacy, Communication And Conflict Resolution, Stella Antony

Doctor of Nursing Practice (DNP) Projects

Background: Rural residents have health disparities more than urban populations. The significant health inequities in the underprivileged population include a higher incidence of chronic diseases, lack of access to healthy foods, health care, health insurance, unhealthy eating habits, poor socioeconomic status, cultural and language barriers, and lack of health literacy. As locals, Community health workers (CHWs) meet these populations and can improve healthy lifestyle changes and advocate for their community.

Local Problem: The population in Fresno and Tulare County in Central Valley, California, is underprivileged, lacks access to proper health care, and has higher rates of health disparities, including chronic …

Empowering Community Health Workers In Guatemala, Oswald M. Attin, Gineska Castillo, Grace Sibert, Andrea Harper

Virginia Journal of Public Health

Introduction:

Community health workers (CHW) have been integral in helping middle- and low-income countries. This research paper discusses the benefits of the involvement of CHWs in health screenings.

Methods:

Health screenings were performed for three rural communities in Guatemala, in 2021, alongside a church in Zacapa, to identify community wide health risks. The screenings included a detailed questionnaire that collected demographic data, height and weight, a blood glucose check, a hemoglobin check, and a blood pressure reading. Additional nutritional data was collected to understand diet patterns and habits. In-depth educational sessions were done with the CHWs, emphasizing preventative care, and …

Implementing Community Health Workers To Improve The Management Of Chronic Non-Communicable Diseases In Children, Julia L. Newell

Doctor of Nursing Practice (DNP) Projects

Background: Childhood obesity, asthma, and untreated mental health conditions are three examples of chronic non-communicable diseases (CNDs) that pose a host of negative consequences later in life. Minority children from low-income families, especially those with environmental disadvantages, face additional risk factors for the development of these diseases. Community health workers (CHWs) are in a unique position to help address these negative health externalities by being attuned with the linguistic, cultural, and socioemotional needs of members of their communities. Research has demonstrated success in CHW-led interventions curtailing the negative impacts associated with these diseases in low-income, minority communities.

Methods: A literature …

Community Health Workers, Stress Reduction, And Racial Equity In Infant Vitality, Justin Rex

ICS Fellow Lectures

How can communities help mothers reduce stress during pregnancy and provide the social supports that contribute to infant vitality? This talk presented findings from an evaluation of the Northwest Ohio Pathways HUB program, a nationally recognized best practice program model that pairs at-risk mothers with community health workers (CHWs) who connect mothers to services that reduce pregnancy risks. The talk included stories from mothers and CHWs about the challenges and stresses they face as well as data from interviews and surveys that quantify the impact CHWs have for reducing mothers' stress and providing supports that help mothers and their children …

Determining Call-To-Entry Rate And Recruitment Barriers In Clinical Studies For Community Clinics Serving Low-Income Populations: A Cohort Study, Elizabeth M Vaughan, Salim Virani, Mahmoud Al Rifai, Victor J Cardenas, Craig A Johnston, Laura Porterfield, Zuleica Santiago Delgado, Susan L Samson, Vanessa Schick, Aanand D Naik

Journal Articles

BACKGROUND: Recruitment for clinical studies is challenging. to overcome barriers, investigators have previously established call-to-entry rates to assist in planning. However, rates specific to low-income minority populations are needed to account for additional barriers to enrolment these individuals face.

OBJECTIVE: to obtain a call-to-entry rate in a low-income uninsured Hispanic population with chronic disease.

METHODS: We used data from four of our randomised clinical studies to determine the call-to-entry rate for individuals (n=1075) with or at risk for type 2 diabetes: participants needed/potential participants contacted=recruitment rate (yield). Research staff contacted potential participants to enrol in a study that evaluated 6 …

Community Health Worker Program: Chronic Non-Communicable Diseases In Children, Julia L. Newell

DNP Qualifying Manuscripts

Abstract

Background: Childhood obesity, asthma, and untreated mental health conditions, are three examples of chronic non-communicable diseases (CNDs) that pose a host of negative consequences later in life. Community health workers (CHWs) are in a unique position to address these negative health externalities by leveraging linguistic, cultural, and socioemotional connectedness within their communities.

Local Problem: Minority children in the Central Valley of California, face additional risk factors for the development of CNDs. CHWs working in this area require enhanced training on CNDs to improve their practice.

Methods: In partnership with Save the Children (STC), the University of San Francisco (USF) …

Engaging Mothers And Community Health Workers: An Online Maternal And Children’S Health Education In Kampung Lio, Indonesia, Shafira Aurelia, Dheanita Nissrina Andini, Garry Soloan, Vahira Waladhiyaputri, Dewi Friska

ASEAN Journal of Community Engagement

To raise awareness and understanding of maternal and children’s health, a team from Faculty of Medicine, Universitas Indonesia, Indonesia, conducted a program called Tinggi Cerdas. It is a community development program in Kampung Lio, Depok, West Java. This article evaluates the impacts of activity related to the participant’s awareness and knowledge about maternal and children’s health. The program was developed and conducted as an online program due to the COVID-19 pandemic situation, from September to December 2021. The program was developed with four different topics through online communication, equipped with an educational booklet for the mothers and a PrimaKu® application …

Community Health Worker Program: Adverse Childhood Experiences And Early Childhood, Arelis Sandoval

Doctor of Nursing Practice (DNP) Projects

Background: Adverse childhood experiences (ACEs) negatively affect childhood development and long-term health outcomes. Latino children face multiple adversities and social determinants of health compounded by ACEs. Community Health Workers (CHWs) have access to work with families to improve resilience and mitigate the effects of ACEs in this population.

Local Problem: In the Central Valley of California, CHWs provide support and resources to a largely Latino population with increased poverty rates, low educational attainment, lack of health insurance, and many chronic health issues, putting families at a higher risk for ACEs exposure. CHWs need further training to apply ACEs knowledge to …

Save The Children Community Health Worker Program – Adverse Childhood Events Prevention, Jieun Lee

Doctor of Nursing Practice (DNP) Projects

Background: Adverse childhood experiences (ACEs) are potentially traumatic events that occur between the ages of 0 to 17 in which are directly associated, in a dose–response manner, to many of the most common and serious health problems in the United States.

Local Problem: 62% of California residents have experienced at least one ACE, and 16% have experienced at least four ACEs. ACEs are linked to nine of the ten leading causes of death in the United States Adults with four or more ACEs are 37.5 times more likely to attempt suicide, 3.2 times more likely to have chronic lower respiratory …

Introducing Motivational Interviewing Skills To Community Health Workers, Stella Antony

DNP Qualifying Manuscripts

Abstract

Background: Rural population accounts for 15% of the population in the United States of America. Rural residents have a higher risk of health disparities than urban populations. The significant health inequities in the underprivileged population include a higher incidence of chronic diseases, lack of access to healthy foods, unhealthy eating habits, lack of access to health care, poor socioeconomic status, lack of health insurance, cultural and language barriers, and lack of health literacy. Local Problem: The population in Fresno and Tulare Counties in Central Valley, California is underprivileged, lacks access to proper health care and has higher rates of …

Utilization Of Community Health Workers In Emergency Preparedness And Response: A Literature Review, Amelia P. Stoltman

Capstone Experience

As the frequency and magnitude of disasters worldwide continues to rise, so too does the devastation that follows. This devastation extends to the whole community. In guidance put forward by the Federal Emergency Management Agency (FEMA), emergency preparedness must be represented in and reflective of the whole community, but marginalized groups or segments of the population may be left out of the conversation. Community Health Workers (CHW)s serve as a trusted liaisons and community advocates within the health care landscape. That landscape, as recent events demonstrate, includes emergency preparedness and response. This literature review is designed to assess available publications …

A Fair Incentive Scheme For Community Health Workers, Avinandan Bose, Tracey Li, Arunesh Sinha, Tien Mai

Research Collection School Of Computing and Information Systems

Community health workers (CHWs) play a crucial role in the last mile delivery of essential health services to under-served populations in low-income countries. Many non-governmental organizations (NGOs) provide training and support to enable CHWs to deliver health services to their communities, with no charge to the recipients of the services. This includes monetary compensation for the work that CHWs perform, which is broken down into a series of well-defined tasks. In this work, we partner with a NGO D-Tree International to design a fair monetary compensation scheme for tasks performed by CHWs in the semi-autonomous region of Zanzibar in Tanzania, …

Effectiveness Of An Integrated Multilevel Early Child Development Intervention On Caregiver Knowledge And Behavior: A Quasi-Experimental Evaluation Of The Malezi Program In Tanzania, Gretchen Antelman, Josephine Ferla, Michelle M. Gill, Heather J. Hoffman, Teopista Komba, Amina Abubakar, Pieter Remes, Ola Jahanpour, Martha Mariki, Mary A. Mang’Enya, Roland Van De Ven

Institute for Human Development

Background The quality of caregiving and the parent-child relationship is critical for early child development (ECD) and has been shown to be modifiable. This study evaluated an ECD project in Tanzania, assessing the effectiveness of radio messaging (RM) alone and a combined radio messaging/video job aids/ECD (RMV-ECD) intervention.

Methods This two-arm pre-post evaluation study enrolled a cohort of caregivers of children 0–24 months in four districts of Tabora region, following them for 9 months. ECD radio messages were broadcast on popular stations at least 10 times/day reaching all study districts. In two districts, community health workers (CHW), trained in UNICEF’s …

Swach Network Map Summary Report: Healthconnect Hub & Broader Ecosystem: Network Maps, Natalie Royal Kenton, Benjamin Gronowski, Sarah E Roth, Hannah Cohen-Cline, Abby Bush

Articles, Abstracts, and Reports

No abstract provided.

Swach 2022 Workforce Report: Understanding The Experiences Of The Healthconnect Hub Workforce, Natalie Royal Kenton, Benjamin Gronowski, Raven Susu-Mago, Abby Bush

Articles, Abstracts, and Reports

No abstract provided.

Core Healthconnect Long-Term Impact Of The Healthconnect Hub By County, Hannah Cohen-Cline, Taylor Doren, Kyle G Jones, Katherine Marsi, Joseph B Rinaldi, Sarah E Roth

Articles, Abstracts, and Reports

No abstract provided.

Core Healthconnect Hub Report Longterm Impact Of Pathways, Hannah Cohen-Cline, Taylor Doren, Kyle G Jones, Joseph B Rinaldi, Sarah E Roth

Articles, Abstracts, and Reports

No abstract provided.

Community Health Worker Certification Program - Motivational Interview, Advocacy, Communication And Conflict Resolution, Stella Antony

DNP Qualifying Manuscripts

Background: Rural population accounts for 15% of the population in the United States of America. Rural residents have a higher risk of health disparities than urban populations. The significant health inequities in the underprivileged population include a higher incidence of chronic diseases, lack of access to healthy foods, health care, health insurance, unhealthy eating habits, poor socioeconomic status, cultural and language barriers, and lack of health literacy.

Problem: The population in Fresno and Tulare County in Central Valley, California, is underprivileged, lacks access to proper health care and has higher rates of health disparities. The Save the Children organization’s Community …

Recruitment, Retention, And Future Direction For A Heart Health Education And Risk Reduction Intervention Led By Community Health Workers In An African American Majority City, Julie Gleason-Comstock, Cindy Bolden Calhoun, Ghadir Mozeb, Cardell Louis, Alex B. Hill, Barbara J. Locke, Victor Harrell, Sadia Yasmin, Liying Zhang, John M. Flack, Nancy T. Artinian, Jinping Xu

Urban Studies and Planning Faculty Research Publications

Heart disease is a leading cause of death for African Americans. A community-academic partnership cross-trained community health workers to engage African American adults in a 6-month heart health education and risk reduction intervention. We conducted a one-group feasibility study using a one group (pre-posttest) design. A total of 100 adults were recruited from 27 zip codes in an African American majority city through community-based organizations (46%), churches (36%), and home visits (12%). Ninety-six percent were African American; 55% were female, 39% were male, and 6% were transgender. Their mean age was 44.6 years (SD=15.9). Ninety-two percent had health insurance. Seventy-six …

The Value Of An Educational Curriculum For Community Health Workers To Decrease Health Disparities, Mandeep K. Gill

DNP Qualifying Manuscripts

Abstract:

Introduction: Community health workers (CHWs) are a group of health care workers that work with underserved populations in rural areas. Community health workers seldom require any formal education for their role, which may cause disparities in the information they present to the populations they serve.

Problem: Underserved communities contain many low-income and marginalized populations that do not have access to adequate healthcare. Healthcare provider shortages can be particularly severe, leaving residents without access to primary care and emergency services from physicians, nurses, and allied health professionals.

Aim/Objective: The purpose of the article is to propose a framework for developing …

Community-Driven Data Revolution Is Feasible In Developing Countries: Experiences From An Integrated Health Information And Surveillance System In Kenya, Anthony Ngugi, Gijs Walraven, James Orwa, Adelaide Lusambili, Maureen Kimani, Stanley Luchters

Population Health, East Africa

Over the period of the Millennium Development Goals (2000-15), it became clear that there was a pressing need and an increasing capacity for a ‘data revolution’ to inform the global health development agenda. In most developing countries, data on key indicators were collected through laborious and retrospective surveys that were as much as five years out-of-date, or through passive reporting systems that relied on routinely generated health facility data. Gaps in the primary data were filled by modelled estimates, which often relied on inadequate assumptions.

The Community Health Worker (Chw) Common Indicators Project: Engaging Chws In Measurement To Sustain The Profession, Keara Rodela, Noelle Wiggins, Kenneth Maes, Teresa Campos-Dominguez, Victoria Adewumi, Pennie Jewell, Susan Mayfield-Johnson

Faculty Publications

Despite progress in documenting the outcomes of Community Health Worker interventions, the lack of standardized measures to assess CHW practice has made it difficult for programs to conduct reliable evaluations, and impossible to aggregate data across programs and regions, impeding commitment to sustainable, long-term financing of CHW programs. In addition, while CHWs have sometimes been involved as data collectors, they have seldom been engaged as full partners in all stages of evaluation and research. This manuscript details the current work being done by the CI Project, demonstrating how CHWs are able to contribute to the integrity, sustainability, and viability of …

Budget Impact And Cost-Effectiveness Analyses Of The Cobra-Bps Multicomponent Hypertension Management Programme In Rural Communities In Bangladesh, Pakistan, And Sri Lanka, Eric A. Finkelstein, Anirudh Krishnan, Aliya Naheed, Imtiaz Jehan, H Asita De Silva, Mihir Gandhi, Ching Wee Lim, Jehanzeb Khan, Samina Hirani, Tazeen H. Jafar

Community Health Sciences

Background: COBRA-BPS (Control of Blood Pressure and Risk Attenuation-Bangladesh, Pakistan, Sri Lanka), a multi-component hypertension management programme that is led by community health workers, has been shown to be efficacious at reducing systolic blood pressure in rural communities in Bangladesh, Pakistan, and Sri Lanka. In this study, we aimed to assess the budget required to scale up the programme and the incremental cost-effectiveness ratios.
Methods: In a cluster-randomised trial of COBRA-BPS, individuals aged 40 years or older with hypertension who lived in 30 rural communities in Bangladesh, Pakistan, and Sri Lanka were deemed eligible for inclusion. Costs were quantified prospectively …

A Scoping Review Of The Roles, Training, And Impact Of Community Health Workers In Oral Health Supplemental Tables, Dina T. Garcia, Jaime Lawson, Erica R. Brody, Susan C. Mckernan, Sarah E. Raskin, Nixon Arauz, Maghboeba Mosavel, Tegwyn Brickhouse

Health Behavior and Policy Publications

Objective: To synthesize English or Spanish-language literature on community health workers’ (CHWs’) roles, training, and impact in oral health. Basic research design: A scoping review conducted in accordance with the Arksey and O’Malley (2005) methodological framework. Method: Electronic literature searches were conducted in Medline (Ovid), Embase (Ovid), DOSS, CINAHL, Web of Science, and Global Health CAB from inception of the databases to April 2020. Three reviewers independently conducted the title and abstract and full-text reviews. This was followed by data charting by three reviewers and data summarizing by two reviewers. Results: Out of the 36 articles that met the inclusion …

Covid-19 Stakeholder Experiences In The Commonwealth Of Kentucky, Center Of Excellence Of Rural Health, University Of Kentucky, Center For Rural Health Research, East Tennessee State University

Center of Excellence in Rural Health Reports

Key Points:

Healthcare providers reported that many in-person services had stopped and that other services were delivered remotely or via telehealth. Some services that were still in-person moved to curbside delivery, including family planning visits. Others described a shift in roles within the community, primarily to support COVID testing.

When asked about the impact of COVID-19, educators described an expansion of roles among staff and a rapid adoption of new technology. Educators also described their staff as being dedicated to meeting the needs of their students including assuring access to food and learning materials for those without reliable internet.

Community …

Community Health Workers And Covid-19 In New York State: Adaptable And Resilient, But Strained, Annis Golden, Amy Williams

Understanding and eliminating minority health disparities in a 21st-century pandemic: A White Paper Collection

This report summarizes findings from an interview-based study conducted in October and November 2020, and inferences that may be drawn from those findings with respect to the contributions of CHWs to eliminating disparities in the impact of COVID-19, and resources needed by CHW-based programs going forward. Findings are reported in the following areas: New connection strategies with clients used by CHWs in response to physical distancing requirements, barriers to connections; new areas of support CHWs provided; socioemotional impact of the pandemic and adaptations on CHWs; resources needed going forward; CHW support for efforts to eliminate disparities in COVID-19 impact on …

Maintaining Population Health In Low‐ And Middle‐Income Countries During The Covid‐19 Pandemic: Why We Should Be Investing In Community Health Workers, Benjamin Palafox, Alicia Renedo, Gideon Lasco, Lia M. Palileo-Villanueva, Dina Balabanova, Martin Mckee

Development Studies Faculty Publications

Community health workers in low- and middle-income country primary health care systems are well suited to perform essential functions on the frontlines of Covid-19 pandemic responses. However, clear and coordinated guidance, updated infection control training, and reliable access to personal protective equipment must be ensured in order to deploy them safely and effectively. With these additional responsibilities, community health workers must also be supported to ensure that hard-fought gains in population health, including progress on non-communicable diseases, are sustained throughout the pandemic.