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Arizona CHW Workforce Study

Arizona CHW Workforce Study. Arizona CHW Workforce Coalition Meeting May 23, 2013 Samantha Sabo DrPH , MPH Zuckerman College of Public Health . Discussion Overview. Rationale Methods Results Facilitated Discussion by Lee and Carl. Rationale and Goals. Rationale. Goals.

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Arizona CHW Workforce Study

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  1. Arizona CHW Workforce Study Arizona CHW Workforce Coalition Meeting May 23, 2013 Samantha Sabo DrPH, MPH Zuckerman College of Public Health

  2. Discussion Overview Rationale Methods Results Facilitated Discussion by Lee and Carl

  3. Rationale and Goals Rationale Goals Paint a picture of Arizona’s CHW workforce Results to serve as a catalyst from which to build consensus on the definition of CHWs from the perspective of CHWs and their employers Facilitate discussion of results with AzCHOW membership during Annual Conference • No known counts of Az CHWs • HRSA Workforce Study 2007 • Lack of consensus among CHWs, CHW Employers and between CHWs and Employers on: • CHW definition • CHW Scope of Practice

  4. Methods Survey : Anonymous, on-line survey of CHWs and Employers/Orgs Development: UA researchers and AzCHOW board members developed the survey. Dissemination : CHW, Promotora and CHR networks, list serves, and personal contacts of members of the CHW Workforce Coalition (April 1, 2013 through May 18, 2013) • CHW Count and Description • Paid versus volunteer • Agency name and type • CHW Job Titles • Definition of CHWs • APHA CHW definition • Perspectives of CHW Scope of Practice • New York State CHW Initiative

  5. Results • 159 total participants • 47 (30%) CHW Employer, Supervisor or Organization • 111 (70%) Community Health Workers • 98% paid for work • All counties represented

  6. Agency Type

  7. Job Titles • Community Health Worker • CHW I, II, III, Senior • Promotora • Community Health Representative • Community Lay Worker • Care Coordinator • Case Manager • Community Health Advisor • Health Educator , I, II • Instructional Specialist • Human Rights Advocate • Lay Leaders • Peer Leaders • Health Systems Navigator • Lay Health Worker • Outreach Program Manager • Outreach Promotora • Patient Navigator • Peer Support Specialist • Public Health Specialist • Educadora de Salud • Public Health Aide • Public Health Specialist • Teen Health Educator • Trainer • Tribal Laison • Well being Promoter • Home Visitor • Office Assistant

  8. CHW Definition American Public Health Association – CHW Section A Community Health Worker (CHW) is a frontline public health worker who is a trusted member of and/or has an unusually close understanding of the community served. This trusting relationship enables the CHW to serve as a liaison/link/intermediary between health/social services and the community to facilitate access to services and improve the quality and cultural competence of service delivery. A CHW also builds individual and community capacity by increasing health knowledge and self-sufficiency through a range of activities such as outreach, community education, informal counseling, social support and advocacy.

  9. CHW Definition Consensus

  10. CHW Thoughts on Definition Cultural expert and cultural educator to organizations in their community A CHW is also the person that adds love and empathy to hes or her work. Me parecequeestamuycompleta …hay vecesque el paciente se abretanto al CHW quetambiennosconfiansusproblemaspersonalesy se le ayuda en lo que se pueda al pacienteclarodandoleanimopositivo. Tal vezseriaconsejeria informalcomo se refiere en la parte de arriba. La Promotoratambienabogao intercede por los clientespacientes Llevar a cabo la MedicinaPreventiva, pormedio de Platicas con temas de: Las enfermedadescronicascomo, Diabetes, Presion arterial, obesidad entre otras a grupos de la Comunidad. Darleseguimiento a casosespecificos de preferenciapreventivos, queestan en riesgo de padecerunaenfermedadcronica. Enfocarnosmas en Salud mental paraapoyar a personas victimas del rechazo social, tantoporsuestatusmigratorio, economicoy cultural.

  11. Employer Thoughts on Definition They help to create change in communities that is culturally, linguistically and community relevant and community driven. Not just a close understanding but an in depth understanding of the issues, barriers and assets of that community that impact health addressing the social determinants of health. I feel that the definition should cut across racial/ethnic cultural lines and also be applicable in rural and urban settings. I believe the definition hits it right on. …Promotoras contribute to the cultural relevancy of the intervention and the cultural equivalence of instruments and educational materials. …should describe specifically the notion of community empowerment …even though is related to increasing community capacity, it is still a different outcome that Promotoras can bring to the table.

  12. Interpersonal and Communication Skills

  13. Teaching and Organizational Skills

  14. Top 5CHW SOP Considered NOT Important

  15. TOP 5CHW SOP Considered VERY Important

  16. Significant Differences – Clinical SOP

  17. Significant Differences : Non Clinical SOP

  18. Clinical SOP Variations

  19. Summary of Difference Between CHWs and Employer • Medical interpretations and filling out medical forms • Participation in Research Projects • Screening ( blood glucose, blood pressure etc. ) • Electronic Medical Records • Interacting with physicians/health care system • Provide social support for clients

  20. FINAL Employer Thoughts on SOP I'd like to see more on future professional development. As much as I don't want to lose my Promoters I want them to move up in their careers. They are so much more talented than their 'resume skills' show. I'd like to see avenues for them to attend some of Pima Community College's medical programs. I think it is important to clarify that CHW's are not medical professionals and cannot diagnose or treat. Informal "counseling" is a concern because they are not licensed counselors. What protects them or the client from working outside of their scope of practice? Proficient in counseling sensitive issues like domestic violence CHW's are expected to know something about almost everything from medical to social, or mental. A lot is being required for a limited amount of education. The expectations of the public or families using the program may be exceeding what the CHW is actually trained for.

  21. FINAL CHW Thoughts on SOP They need trainings about safety and how to protect from risk situations like when they attending domestic violence clients, drugs dealer partners etc. Community organizations need to understand that the CHW's scope of work varies on a daily basis. Because working with the community is so important, organizations need to know that a CHW can one day work in her office and the next she could be out in the community. Organizations that are new to this model have different expectations for the CHW so it has to be communicated from the beginning that this position can change a million times and that the most important thing is the relationship building and being out in the community. Es muyimportantequetambienlas/los promotoras/esestensiendoconstantementecapacitadosparaestarmas al dia con lasnecesidades de los clientesyorganizaciones.

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