Center for Healthy Communities

Katherine L. Cauley, Ph.D., Director

Community Health Advocate Program

Who are Community Health Workers (CHWs)?

Community health workers are lay members of the community, either paid or volunteer, who work with the local health care system in rural and urban communities. They usually share the same cultural and ethnic background of the community members they serve. CHWs provide an essential link between the community and the health and human services system. Their activities are numerous and varied, depending on the need and the program in which they work.

Community Health Workers:

  • Are from the communities they serve
  • Are most often female
  • Receive training in principles of health advocacy and referral
  • Are aware of current resources available to the community

Community Health Workers provide the following services to the community:

  • Culturally appropriate health care information and education
  • Linking to community resources
  • Assistance and advocacy for underserved individuals to receive appropriate services (navigation)
  • Promotion of community participation in health promotion/disease prevention activities
  • Inform providers about cultural health beliefs and practices of clients served
  • Identify community needs for which there are not available resources
  • Informal counseling and referral

Community Health Advocates

The CHC Community Health Advocate (CHA) Program

The Community Health Advocate (CHA) Program, an integral component of the Center for Healthy Communities from its beginning, evolved out of a request from community members who said they wanted someone who “looks like me and talks like me” to help reduce barriers to accessing health and human services in the community.

Since 1993, the Center for Healthy Communities CHA Program has used CHAs to assist underserved community members to access services that enhance broad determinates of health. CHAs strive to assist individuals/families with health and social service problems by providing information on community resources, necessary support and follow up. They are sensitive to social, economic, and cultural community issues.

Some of the ways in which CHAs have helped community members are as follows:

  • Since the expansion of Ohio’s Healthy Start/Healthy Families initiative in 2000, the Community Health Advocates have done outreach to inform clients about this program and to assist them in applying for the program.
  • The Kinship Caregiver Coalition uses Community Health Advocates known as Kinship Navigators to assist grandparents and other relatives who are raising relative children to locate and access services that can help them.
  • In the first part of 2008, a CHA worked with seniors who were at risk of losing deemed eligibility for the Medicare Low Income Subsidy (LIS) program. The advocate assisted some of them to reapply for LIS and helped others to apply for the first time.
  • At an area hospital, a CHA assisted patients to enroll in Medicaid, significantly reducing uncompensated care costs. In addition, the advocate linked patients to resources including food, shelter, job training, support groups and other services.
  • Past CHC programs and projects where CHAs have played an essential role include:
    • HealthLink Miami Valley - HIEx™
    • Alliance for Research in Community Health
    • Reach Out of Montgomery County
    • American Heart Association
    • Kellogg Project
    • HUD Lead Hazard Control
    • Department of Education
    • Dayton Community Outreach Program
    • Susan G. Komen Breast Cancer Screening
    • Ameritech
    • Health Power

In addition to client navigation and referral, Community Health Advocate Program provides outreach services:

  • Providing resources at health fairs
  • Speaking to interested groups about the role of community health advocates and the Community Health Advocate Program
  • Helping other organizations establish community health worker programs

For more information about the CHC Community Health Advocate Program, contact Kimberly Conner, Community Health Advocate Outreach Program Coordinator, at kimberly.conner@wright.edu or (937) 775-8254.

Community Health Worker Training Programs

CHC Community Health Advocate Course

In order to ensure consistency in CHA preparation and training, the Center for Healthy Communities developed a six-week course, Introduction to Community Health Advocacy. The course introduces students to community health concepts, resources, and skills related to the role and responsibilities of a Community Health Advocate, both locally and nationally. Special emphasis is placed on factors to consider when working in community-based settings; characteristics of health models and plans; impact of culture and socioeconomic status on the health of the individual; communication; barriers to health care services; anticipated health care needs across the life span; and related community resources.

Community Health Worker Curriculum – Ohio Department of Health

Working in partnership with the Ohio Department of Health, the Center for Healthy Communities developed a course that could be offered in community colleges across the state to prepare Community Health Workers/Advocates to provide cardiovascular health education and help link community members to needed resources.

Links Related to Community Health Workers/Advocates and CHW Programs

Research

Rosenthal E, Brownstein J, Rush C, Hirsch G, Willaert A, Scott J, Holderby L, Fox, D. Community Health Workers: Part of the Solution. Health Affairs, Vol. 29, No. 7, 1338-1342 (2010).

Brownstein JN, Chowdhury FM, Norris SL, Horsley T, Jack L Jr, Zhang X, Satterfield D. Effectiveness of community health workers in the care of people with hypertension. Am J Prev Med. 2007 May;32(5):435-47.

U.S. Department of Health and Human Services, Health Resources and Services Administration. Community Health Workforce National Study, March 2007.

Ingram M, Torres E, Redondo F, Bradford G, Wang C, O'Toole M. The Impact of Promotoras on Social Support and Glycemic Control Among Members of a Farmworker Community on the US-Mexico Border. The Diabetes Educator, Vol. 33, No. Supplement 6, 172S-178S (2007).

Robert Wood Johnson Foundation. Locally Recruited Lay Advisors Contribute to Community Health. October 2006.

Kuhajda MC, Cornell CE, Brownstein JN, Littleton MA, Stalker VG, Bittner VA, Lewis CE, Raczynski JM. Training community health workers to reduce health disparities in Alabama's Black Belt: the Pine Apple Heart Disease and Stroke Project. Fam Community Health. 2006 Apr-Jun;29(2):89-102.

Dower C, Knox M, Lindler V, O’Neil E. Advancing Community Health Worker Practice and Utilization: The Focus on Financing. San Francisco, CA: National Fund for Medical Education. 2006.

Krieger JW, Takaro T K, Song L, Weaver M. The Seattle-King County Healthy Homes Project: A Randomized, Controlled Trial of a Community Health Worker Intervention to Decrease Exposure to Indoor Asthma Triggers.  American Journal of Public Health, 2005 April; 95(4):652-659.

Wendel M, Burdine J, Dorsey A, Blakely CH, Zuniga R. Changing Roles of Promotoras. Academy Health. Meeting (2004 : San Diego, Calif.). Abstr Academy Health Meet. 2004; 21: abstract no. 1035.

Rodney M, Clasen C, Goldman G, Markert R, Deane D. Three evaluation methods of a community health advocate program. Journal of Community Health, 1998 Oct; 23(5):371-381.