Community Health Worker (CHW) programs offer essential links between communities and health care. Project H.E.A.L., a 3 year initiative, was an academic-community partnership between Johns Hopkins University Medicine and Nursing and the East Baltimore Community. The program was initiated in response to increased Pediatric Emergency Department use for acute minor illnesses. Its purpose was to foster empowerment and competence among families in dealing with their children in health and illness. A summative program evaluation showed the greatest impact was linkages between theoretical constructs of self-efficacy and community capacity building and the daily work of home-visiting. Five CHWs had 1226 contacts with 127 families over the program's term. What CHWs do is often unclear. This evaluation demonstrated CHWs listen, support, teach, and problem-solve with clients. Contacts between CHWs and clients served to build self-efficacy. Referrals to community resources also served to increase client self-efficacy. These referrals also constitute a crucial step towards increased community capacity building, as it links the community to its own resources. In addition to client self-efficacy, CHW self-efficacy was increased through Friere's learner-centered model of adult education. However, inability to demonstrate quantifiable outcomes in a timely manner resulted in loss of additional funding. Valuable lessons were learned. These included experiencing challenges in: creating true sustainable programs, using partnership strategies appropriately, shifting from academic to community accountability, completing thorough and accurate documentation, developing community agencies as clients, and using formative evaluations effectively. Nevertheless, building self-efficacy and community capacity is a most valuable lesson for CHW programs.
Learning Objectives: At the conclusion of the session, the participant will be able to: 1) Describe challenges in evaluating CHW programs. 2) Identify opportunities to link theoretical constructs of self-efficacy and community capacity to daily work of community health workers. 3) Identify mechanisms to improve community health worker project evaluation process from program inception
Keywords: Community Health Advisor, Evaluation
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.