263500 Predictors and a Framework for Fostering Community Advocacy as CHW Core Function to Eliminate Health Disparities

Monday, October 29, 2012

Samantha Sabo, MPH , Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ
Maia Ingram, MPH , Deputy Director, Arizona Prevention Research Center, University of Arizona, Tucson, AZ
Kerstin Reinschmidt, PhD, MPH , Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ
Floribella Redondo , Campesinos Sin Fronteras, Somerton, AZ
Scott Carvajal, PhD, MPH , Health Behavior Health Promotion, Division of Health Promotion Sciences, University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, AZ
Kenneth Schachter, MD , Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ
Jill de Zapien, BA , Associate Dean for Community Programs, University of Arizona Mel and Enid Zuckerman College of Public Health (UA MEZCOPH ), Tucson, AZ, AZ
Lourdes Fernandez, Promotora , Arizona Community Outreach Workers Network, Nogales, AZ
Laurie Robinson, MTS , Wellness and Health Promotion, El Rio Community Health Center, Tucson, AZ
Lucy Murrieta , Health Promotion, Sunset Community Health Center, Somerton, AZ
Rosalinda Piper , Health Promotion-Disease Prevention, Mariposa CHC, Nogales, AZ
Marilyn Godfrey , Program Coordinator Health Start, Cochise County Health Department, Sierra Vista, AZ
Mariajose Almazan , Director, Community Resources and Program Development, Regional Center for Border Health, Someton, AZ
Susan Kunz, MPH , Platicamos Salud, Mariposa Community Health Center, Nogales, AZ
Yolanda Ochoa, Promotora , Regional Center for Border Health, Somerton, AZ
Judith Gilligan , Public Programs, Personal Service, Cochise County Health Department, Bisbee, AZ
Ila Tittelbaugh, RN , Pima County Health Department, Tucson, AZ
Community Health Workers (CHWs) are in the unique position of recognizing environmental and structural barriers facing marginalized populations. Their sense of identity with the communities they serve both compels and positions CHWs to take action in the face of these challenges. Objective: The National Community Health Workers Advocacy Study (NCHWAS) is a mixed-methods, community based participatory research (CBPR) project investigating the impact of CHW advocacy on community engagement to address the social determinants of health (SDH). Based on this study, we present a framework for conceptualizing and measuring ways in which CHWs engage in advocacy activities, and mechanisms to support CHW advocacy efforts beyond the individual client level. Methods: Cross sectional survey data for 371 CHWs, from 22 US states assessed socio demographic measures; CHW training experience, characteristics of CHW work environment and duties; and CHW leadership qualities on CHW civic, political and own agency advocacy. CHW advocacy stories further articulate CHW advocacy efforts at civic, political, and own agency levels. Results: 75% of CHWs respondents engaged in some type of advocacy. Factors that significantly contributed to CHW advocacy included leadership and advocacy training, work setting, job description, and CHW leadership qualities. Conclusions: CHWs recognized by their community, employer, and community leaders as a trusted member of community opinion can be supported by including community advocacy as central to CHW job description, delineating specific advocacy activities in line with institutional mission and project goals and identifying and providing skill building that prepare CHWs to organize and advocate effectively.

Learning Areas:
Advocacy for health and health education
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Describe the predictors of CHW community level advocacy. Describe ways in which CHW community level advocacy may be supported by CHW work environment and training.

Keywords: Community Health Promoters, Advocacy

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conceptualized the research study and conducted the analysis.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.