142nd APHA Annual Meeting and Exposition

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301764
Facilitators and Barriers to the integration of CHWs in a Safety Net Clinic: Perspectives from the clinical team

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014

Megha Shah, MD, MSc , Department of Family Medicine, University of Michigan/Robert Wood Johnson Clinical Scholars Program, Ann Arbor, MI
Gloria Palmisano, BS, MA , REACH Detroit Partnership, Detroit, MI
Michele Heisler, MD MPA , University of Michigan, Ann Arbor, MI
Edith Kieffer, MPH, PhD , School of Social Work, University of Michigan, Ann Arbor, MI
Denise Pike, AICP , CHASS Center, Inc, Detroit, MI
Marylu Villarreal, BBA , CHASS Center, Inc., Detroit, MI
Jaye Clement, MPH/MPP , Office of Community Health, Equity & Wellness, Henry Ford Health System, Detroit, MI
Monica White, MPH , Institute on Multicultural Health, Henry Ford Health System, Detroit, MI
Zachary Rowe, BBA , Friends of Parkside, Detroit, MI
Purpose: There is growing evidence of the benefits of community health workers (CHWs) in primary care for low resource settings. The Affordable Care Act encourages the utilization of CHWs in health teams.  Little is known about how traditional health team members understand the role of CHWs in safety net systems.  Accordingly, this study explores the perceptions of traditional health team members and CHWs about the roles and potential contributions of CHWs in care teams, within a federally qualified health center in Detroit, MI. 

Methods: Using community-based participatory research (CBPR) principles, a committee from Community Health and Social Services (CHASS) Center, Inc., local community-based organizations and health systems, and academic partners developed collective specific aims and interview guides.

Qualitative, one-on-one, semi-structured interviews with 14 current providers, nurses, medical assistants, social workers, and community health workers were conducted at CHASS Center.  Interviews were audio-recorded and transcribed.  The committee used an iterative analysis process to identify common themes.

Results: Key barriers to integrating CHWs into care teams include low knowledge, lack of clarity on roles, clinical staff did not identify CHWS as members of the patient care team, and limited direct interaction among clinical staff.  Facilitators include receptiveness to learn more, interest in working together on a team, and value of potential collaboration. 

Conclusions:  Creating more opportunities for face to face interaction among clinical staff members and CHWs and providing orientation and education about CHWs may aide in integrating CHWs into health care teams for safety net settings.

Learning Areas:

Administration, management, leadership
Program planning

Learning Objectives:
Describe key barriers to integrating CHWs on patient care teams in a safety net setting Identify facilitators to aid in the integration of CHWs Describe methods to address barriers to CHW integration Discuss next steps needed from clinical staff and CHW perspectives to integrating CHWs onto patient care teams

Keyword(s): Community Health Workers and Promoters, Community Health Centers

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the project manager overseeing multiple federally funded grant projects of the REACH Detroit Partnership that addresses racial and ethnic health disparities in type 2 diabetes among Latinos and African Americans. In these endeavors I have gained expertise in the use of community health worker model and community-based participatory research methods to address chronic disease management among low-income, urban populations.
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.

Back to: 4372.0: Novel approaches to supporting, evaluating and enhancing the CHW profession and CHW programs