Abstract
Patient Sorting into Intensity-based tracks of a Kansas City CHW program
Rebecca Burns1, Jessica Williams, PhD, MA2, Joanna Brooks, MBE, PhD3 and Tami Gurley-Calvez, PhD4
(1)Kansas City CARE Clinic, Kansas City, MO, (2)KUMC, Kansas City, KS, (3)University of Kansas Medical Center, Kansas City, KS, (4)University of Kansas, Kansas City, KS
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
The greater bi-state Kansas City area has a demonstrated need for opportunities to increase access to healthcare and improve health outcomes for underserved communities. An existing community health worker (CHW) program run by KC Care connects clients from various referral sources to one of two CHW programs differentiated by their intensity. The first level program gives patients at area Emergency Rooms and clinics information about health and social services based on need. If patients need to be connected to non-emergent healthcare, an assigned CHW assists the patient by making an introductory appointment and attending with them if needed. The second level program draws clients from a variety of sources and connects clients with a CHW for potentially renewable 60-cycles during which time, the CHW assists the client with healthcare needs as well as social services needs based on pre-set goals developed collaboratively with the client. This project, a collaboration between researchers and CHWs, will describe the components of the two programs and identify current mechanisms for client sorting into each program. The current sorting mechanism depends on both the individual CHW and the client's willingness to accept services but the exact mechanisms for enrollment are not clear. Using qualitative interviews and surveys, the research group will describe the existing mechanisms for sorting clients into the different program tracks. The presentation will feature multiple presenters (at least one of whom will be a CHW).
Administer health education strategies, interventions and programs Conduct evaluation related to programs, research, and other areas of practice
Abstract
A Day-in-the-Life of a CHW Integrated in a Care Team Reducing Health Disparities and Improving Health Outcomes
Crystal Korpi
Michigan Primary Care Association, Lansing, MI
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
With a Community Health Worker (CHW) presenter, a typical day for a CHW in an integrated team is nothing but typical. Community Health Workers are change agents reducing health disparities and positively impacting social determinants of health. Each patient has different health concerns, social needs, and capabilities.
A CHW integrated into a traditional health care team helps support the non-clinical needs of patients by linking them to community resources and supports. A CHW encourages a shared healthcare-decision making environment where the patient is the leader of the goals. The patient being the captain of his or her care team is encouraged to take responsibility for empowering themselves to overcome obstacles in the future with the support of a CHW. The CHW promotes behaviors that reduce risk and prioritize wellness including improved medication and treatment plan adherence. CHWs do not replace existing team members but instead add efficiency to the team, lead the team in identifying patient barriers including housing, transportation, health literacy, education, etc. and a trusted liaison between the Health Centers and communities. A CHW integrated into a care team has the ability to meet a patient in the clinic or to go to where the patient is. A home visit may reveal a true picture of reality for the patient.
CHWs in Michigan have alignment opportunities with many agencies such as Medicaid Primary Care Health Homes, developing relationships with Health Plans, Health System direct employment State Innovation Model, future projects such as pending bid for Accountable Health Communities.
Advocacy for health and health education Chronic disease management and prevention Implementation of health education strategies, interventions and programs Other professions or practice related to public health
Abstract
Primary care based community health workers: Bringing community lessons to the primary care practice
Judith Schaefer, MPH1, Lisa LeRoy, PhD, MBA2 and Heidi Berthoud, MPH1
(1)Group Health Research Institute, Seattle, WA, (2)Abt Associates, Cambridge, MA
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
Community health workers (CHWs) are a significant force in the response to the growing primary care clinician scarcity and the reorganization of primary care to respond to the needs of complex and vulnerable populations. As such, they are taking an increasingly important role in the primary care team as a source of patient facing interventions and outreach. The authors describe team configurations that include innovative roles for CHWs and characterize promising models of primary care delivery, assess their financial feasibility and sustainability. Data sources include extant data on primary care staffing from 75 innovative practices (many serving as patient centered medical homes), case studies of nine exemplar primary care practices, literature review and an expert workgroup. The authors describe critical functions performed by CHWs in exemplary primary care practices where teams are leading the way in innovations to deliver fully-comprehensive, high-quality primary care. As extenders of the care team into the home CHWs feed information back into the primary care team. CHWs provide home visits to assess environmental and social barriers to chronic illness management, monitor symptoms, and develop a full picture of the patient setting to inform a more robust care plan. They collaborate with patients to operationalize the treatment plan in the home setting, do goal setting and behavioral support and connect patients with social service resources. In case study practices, CHWs are seen as an extension of the primary care team providing quality, equitable care, and addressing diverse needs of populations.
Chronic disease management and prevention Clinical medicine applied in public health Implementation of health education strategies, interventions and programs Provision of health care to the public
Abstract
Documenting community health worker roles and integration in community health centers in southern Arizona: Contributions to evidence-based and locally relevant CHW integration
Kerstin M. Reinschmidt, PhD, MPH1, Maia Ingram, MPH1, Stephanie Morales1, Samantha Sabo, DrPH, MPH2 and Scott Carvajal, PhD, MPH3
(1)University of Arizona, Tucson, AZ, (2)Zuckerman College Public Health, University of Arizona, Tucson, AZ, (3)Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
The Affordable Care Act provided community health workers (CHWs) with new opportunities in a restructuring health care system, and a renewed recognition of their contributions to improving health care access, promoting health, and reducing health disparities. Consequential efforts of integrating CHWs in patient-centered clinical care teams are generating evidence-based guidelines for CHW integration that are anchored in the literature on CHW roles, trainings, and programs. Integration also poses practical questions such as the level of CHW access and contribution to electronic medical records (EMR). Researchers at the Arizona Prevention Research Center are contributing to current efforts of developing evidence-based and locally relevant guidelines for CHW integration into clinical teams focused on chronic disease. We documented CHW roles and activities in three federally qualified health care centers (FGHCs) in southern Arizona. Using qualitative methods, we reviewed CHW job descriptions, observed CHWs during full work days, and conducted focus groups with health care teams. Data were analyzed thematically and triangulated, and consensus was built among research team and partner organization members. CHW clinical roles and activities reflected those described in the literature, but varied by health center. Integration occurred on multiple levels and included complementary roles, scheduled and everyday communications with team members, and documentation in the EMR. At each FQHC, CHW roles and their integration were in flux. These findings will be presented and the audience will be invited to comment on CHW integration in their own organizations and on our locally appropriate, evidence-based guidelines for CHW integration into clinical teams.
Public health or related research
Abstract
Building Bridges to Care: Strategies to Better Serve the Latino Population in Southeastern Louisiana
Diona Walker, MSPH1, Shondra Williams, PhD1, Laila Fox, MUP, MPH2 and Maureen Lichtveld, MD, MPH2
(1)Jefferson Community Health Care Centers, Inc., Avondale, LA, (2)Tulane University, New Orleans, LA
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
Tulane's Center for Gulf Coast Environmental Health Literacy, Research and Strategic Initiatives partnered with Jefferson Community Health Care Centers (JCHCC) to implement a community health worker (CHW) program aimed at increasing access to health care services. Tulane's Environmental Health Capacity and Literacy Project, part of the Gulf Region Health Outreach Program, was developed after the 2010 BP oil disaster to build social capital and engage communities. JCHCC has served the linguistically and culturally diverse community of Jefferson Parish, Louisiana, since 2004. 11% of their patient population identities as Latino and the population is growing. JCHCC has identified the Latino population as one of the most vulnerable in Jefferson Parish due to low educational attainment, language barriers and lack the knowledge required to navigate a health care system. To address this need, JCHCC has leveraged successful partnerships with respected entities within the Latino community, including the Honduran Consulate and a local hospital's Children's Health Project. These partnerships have attracted an influx of Latino patients seeking services and together with JCHCC's CHW program, staff are able to assist with cultural sensitivity and negate barriers to care. This roundtable presentation by JCHCC's CHW team will describe innovative ways utilized to reach the Latino population through social media, radio and bilingual periodicals, ultimately building trust. This has been essential to coordinate services for patients and their families, provide education regarding health care services in the area, assist with applying for state funded social services, and coordinate appointments and referrals for Care Management.
Administer health education strategies, interventions and programs Diversity and culture Planning of health education strategies, interventions, and programs