Online Program

CHWs Linking Primary Care and Public Health Services: A Community-Engaged Process for Developing the CHW Role

Wednesday, November 4, 2015 : 9:06 a.m. - 9:18 a.m.

Jennifer Leeman, DrPH, MDIV, School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC
Alexis Moore, MPH, University of North Carolina at Chapel Hill, Comprehensive Cancer Control Collaborative of North Carolina (4CNC), Carrboro, NC
Cherie Rosemond, PT, PhD, GCS, Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, NC
Michelle Schreiner, MSN, RN, PCCN, School of Nursing, University of North Carolina at Chapel Hill, Raleigh, NC
Samuel Cykert, MD, Division of General Medicine and Clinical Epidemiology and NC Area Health Education Centers Program, University of North Carolina Chapel Hill, Chapel Hill, NC
Although Community Health Workers (CHW) are effective at reaching underserved populations and promoting health, evidence is limited on how best to integrate CHWs within primary care and public health settings or to plan for broad scale implementation of the CHW role. Most notably, evidence is limited on CHW selection, training, scope and practice, and supervision. We address this gap by testing a novel, community-engaged strategy that employs CHWs to leverage and link the strengths and services of primary care and public health and thereby promote cardiovascular health in a rural county that ranks 94th (of 100 NC counties) for healthy behaviors, and whose population is predominantly African American (60%) and low income (26% living in poverty). CHWs will be integrated as members of both primary care and public health teams and equipped with tablet computers designed to support delivery of an evidence-based health education intervention, referral of at-risk clients to community resources, and communication with clinic and public health teams. The 5-year project applies a community-engaged hybrid effectiveness-implementation trial design with three phases: (1) develop CHW role, (2) test impact on effectiveness and implementation outcomes, and (3) adapt and replicate in a second county and plan for taking the CHW role to scale. We will report findings from the project’s first phase: how we engaged community partners; formative data collected via focus groups, key informant interviews, windshield tours, GIS mapping, and team meetings; CHW job description, training and supervision plans; and practical measures to evaluate CHW implementation and impact.

Learning Areas:

Assessment of individual and community needs for health education
Chronic disease management and prevention
Planning of health education strategies, interventions, and programs

Learning Objectives:
Explain an approach to engaging community partners in developing a CHW job description and training and supervision plans. Describe practical measures that communities can use to evaluate CHW implementation and impact. Discuss a model in which CHW’s serve as members of the medical neighborhood team and thereby strengthen linkages between primary care and public health services.

Keyword(s): Chronic Disease Prevention

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an assistant professor in the School of Nursing, University of North Carolina at Chapel Hill. My scholarship focuses on implementing evidence-based interventions with a focus on interventions to prevent disease and promote health in at-risk populations. I am Co-PI of a CDC-funded implementation/effectiveness trial of a community health worker-delivered intervention designed to link clinical and public health services for the purpose of preventing cardiovascular disease in a rural, predominantly African American county (2014-2019).
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.