Online Program

Understanding the Role of Community Health Representatives in Building Community Resilience in Native Communities

Monday, November 2, 2015

Nicolette Teufel-Shone, PhD, Health Promotion Sciences, University of Arizona, Mel and Enid Zuckerman College of Public Health (UA MEZCOPH), Tucson, AZ
Mae-Gilene Begay, MSW, Community Health Representative Program, Navajo Nation Division of Health, Window Rock, AZ
Samantha Sabo, DrPH, MPH, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ

Kerstin Reinschmidt, PhD, MPH, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ
Tara Chico, MPH, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ
Community health representatives (CHRs) provide services in most federally recognized tribes. Indian Health Service (IHS), the umbrella organization for CHR programs, clearly outlines advocacy as a core CHR function. Yet, their role as health advocates and promoters of community resilience is not well documented. Our preliminary data collected through the 2014 National Community Health Worker Advocacy Survey demonstrates that 89% of CHRs reported advocating with and for their community, yet only 40% have received formal advocacy training. Objective: The aim of this university-community project was to use a participatory approach to engage CHRs in defining training interests related to community advocacy and resilience. Methods: Through a series of face to face listening sessions, CHRs explained their current experience with community advocacy and promoting resilience strategies and explored the feasibility of adapting an evidence-based community health worker leadership and advocacy curriculum to CHR programs. Results: Listening sessions strengthened the foundational trust between the university and CHR programs. CHRs’ skills related to advocacy and resilience strategies drew on personal experience and were not considered part of their practice based tool kit. CHRs used a consensus process to lead the modification of the available curriculum. The curriculum will be delivered and community impact assessed. Conclusion: CHRs are well positioned to advocate for their communities to enhance resources and services to reduce health disparities and increase community resilience. If the modified curriculum yields a measureable impact on community health and resilience, training will be proposed as an addition to CHR training and skills policies.     

Learning Areas:

Advocacy for health and health education
Diversity and culture
Other professions or practice related to public health

Learning Objectives:
Define health advocacy and community resilience. Describe CHRs’ current role as health advocates and promoters of community resilience. Describe how advocacy and resilience could influence policies governing CHR training and skill set.

Keyword(s): Community Health Workers and Promoters, Native Americans

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I serve as an advisory committee member to the Center for American Indian Resilient (CAIR) which works closely with the Northern Arizona University and University of Arizona via a joint grant. As the program director of Navajo CHR/Outreach program and partner with CAIR, I am qualified to co-present with the University of Arizona staff who are part of the CAIR project. I received my MSW from University of Denver.
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.