Training Community Health Workers to Deliver In-Home Education: Processes, Challenges and Lessons Learned

Problem: Community Health Workers(CHWs) are often utilized to provide health education in the home. Providing consistent education and quality control is difficult because of the chaotic environment and other challenges CHWs face.

Approach: The Community Asthma Prevention Program(CAPP) of the Children's Hospital of Philadelphia has eleven years experience in the role of CHWs to provide in-home caregiver/patient education and environmental mitigation in the inner-city in order to improve health outcomes for children. CHW's have participated in planning and conducting community surveys using “street corner” and “door-to-door” methodologies. Utilizing a centralized approach to supervision and training has led to consistency in patient/caregiver education, data collection, safety and environmental mitigation. CHW's ongoing training process includes 1)initial didactic lessons 2)demonstration of lesson for peer review 3)on-site observation 4)buddy visits 5)independent visits 6) monthly booster sessions. In this session we will discuss the essential components in training curriculum for CHW's to provide caregiver/patient education including identification of learning styles and adaptation of curriculum, education in a chaotic environment and development of strategies to improve effectiveness in home education. Advantages of centralization of training and supervision will be discussed. A CHW will describe her experience, challenges and strategies in implementing education in the home. Outcomes including pre/post knowledge tests, asthma symptoms and quality of life will be presented.

Lessons Learned: CHW training needs to be ongoing with constant feedback. CHWs often contribute to their own learning by identifying strategies to effectively deliver education. Centralization of supervision and training promotes CHW consistency in implementation and effectiveness.