Online Program

Innovative approaches to implementing a community health worker-led curriculum: An evaluation of the national heart, lung, and blood institute's community health worker health disparities initiative

Monday, November 4, 2013 : 12:50 p.m. - 1:10 p.m.

Yusra Shawar, MPH, Altarum Institute, Alexandria, VA
Jodi Anthony, MPH, Altarum Institute, Washington, DC
Jovonni R. Spinner, MPH, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD
Gloria Ortiz, MS, Division for the Application of Research Discoveries (DARD), National Heart, Lung, and Blood Institute (NHLBI), Bethesda, MD
Sherri Farias, Altarum Institute, Washington, DC
Heart disease disparities continue to exist among ethnic and minority groups. Research shows that the elimination of health disparities requires locally-driven solutions. The National Heart, Lung, and Blood Institute's (NHLBI) Community Health Worker (CHW) Health Disparities Initiative funded nine “Strategic Champions” to implement a CHW-led heart health curriculum among minorities who are disproportionately affected by heart disease. The Champions, which include universities, community-based organizations, tribal entities, and area health education centers, adapted and implemented one of NHBLI's twelve session manuals in various innovative ways. Champions were given flexibility in terms of how they built partnerships, how they taught the curriculum to and supported CHWs, and how the curriculum was implemented by CHWs in the community. Quantitative surveys are employed to assess changes in CHWs heart health knowledge, attitude, and teaching confidence before and after being trained on the curriculum, as well as community member knowledge, behavior, and confidence change before and after completing the curriculum. Qualitative data such as video/photo voice, focus groups, and key-informant interviews are collected to characterize each Champion's unique implementation approach. Preliminary results demonstrate an improvement in CHW knowledge, attitude and teaching confidence and community member knowledge, behavior and confidence. Final results showcasing the differential impact and reach of the innovative strategies will be presented. There must be a careful balance of maintaining curriculum fidelity while also fostering community-driven strategies. By using a cross-site evaluation with a core set of metrics, the impact that various approaches had on CHWs capacity and community participants' is documented.

Learning Areas:

Administer health education strategies, interventions and programs
Conduct evaluation related to programs, research, and other areas of practice
Diversity and culture
Implementation of health education strategies, interventions and programs
Public health or related research

Learning Objectives:
Describe lessons learned and innovative approaches used to successfully implement and adapt NHLBI’s heart health curricula in communities most at risk for cardiovascular disease. Evaluate the impact that various Champion-specific training and support strategies implemented has had on community health worker knowledge, attitude, and confidence by training and support strategies provided to CHWs. Evaluate the impact that various Champion-specific community education adaptations has had on community member knowledge, behavior, and confidence after undergoing a community health worker-led educational session. Discuss the practical implications of these findings for organizations working with CHWs in their health intervention work.

Keyword(s): Community Health Promoters, Health Disparities

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a Senior Associate in the area of Health Equity and Health Disparities at Altarum Institute. I have worked extensively on the implementation of the National Heart, Lung, and Blood Institute's (NHLBI) Community Health Worker (CHW) Health Disparities Initiative.
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.