Health Works!: A CHW-driven "Worksite" Wellness Program for the Unemployed/Uninsured

The Wellness and Workforce Development Program, also called Health Works! is a three-year collaborative between a community-based workforce development program, and a local academic institution. The objectives were to: increase access to primary health care for community residents; provide outreach/education on specific health issues to community residents; and provide four community residents with a set of transferable employment skills. Four graduates of the job readiness program were recruited and trained as Community Health Workers (CHWs) to return to their community and provide health education classes for difficult-to-employ adults in a low-income urban community. This is essentially a "worksite" wellness program -- except participants are unemployed and mostly uninsured adults. CHWs present an intervention with four modules, including general disease prevention measures; access to care; mental health and coping with stress; and, emergency preparedness. The CHWs worked to help create a curriculum that would best serve individuals and families in these disadvantaged communities. The majority of the participants in the classes are marginalized in terms of employment due to low educational achievement and inability to pass background checks due to criminal records. The CHWs have similar difficulties and had to be hired through a subcontract with the community-based agency. They came highly recommended by program administrators of the job training program to deliver health information to the community. Since its introduction in 2006, the Health Works! program has been invited expand their reach and their partnerships to public health, government, and private agencies. To date, over 1,100 unemployed adults have participated in this program and demonstrated significant improvement in knowledge, attitude, and self-efficacy to better negotiate for health care services. The CHWs have reached an additional 554 senior adults in the implementation of an evidence-based colorectal cancer intervention. The same four CHWs have been retained since the onset of the program. Well-trained CHWs have demonstrated they can be of great benefit to the healthcare system and for at-risk community residents, potential employees/employers. Community-academic partnerships can provide new employment opportunities for CHWs; and have a positive impact on communities with many challenges from a variety of social determinants of health.