Community Health Workers (CHW) / Promotoras
What is a Community Health Worker/Promotor(a) de Salud?
According to the CDC (2015), community health workers (CHWs) go by many names — community health advocates, lay health educators, community health representatives, promotores de salud, etc. — and are members of any given community that help bridge the gap between healthcare providers and communities that lack access to care.
CHWs serve as liaisons between individuals in the community and health care and social services. The effectiveness of CHW outreach stems from their close understanding of the ethnicity, language, socio-economic status, and life experiences of the community served.
CHW’s can serve in a range of capacities, including:
- Patient navigation and follow-up
- Community health education and information
- Informal counseling
- Social support
- Participation in clinical research
The SCAETC at Parkland sat down with the Director of DFW Community Health Workers Association to discuss CHWs and the HIV Care Continuum. Click to learn more about CHWs and how CHWs and other healthcare professionals work together!
CHWs in the Clinical Setting
Integrating Community Health Workers into health care teams is becoming increasingly important as public health practitioners address rising health care costs.
Public health practitioners, in collaboration with CHWs, can improve health outcomes by:
- Providing support and counseling
- Linking patients with key support services
- Helping patients understand and address behavioral and social risks to their health
- Providing community outreach in needed areas
- Addressing barriers and increasing use of services by
- Translating when language is a barrier
- Providing referrals for needed services
- Helping patients understand, in plain language, instructions from health care providers
- Assisting with lack of transportation, completing required paperwork, or other barriers
- Establishing connections and providing education
- Identifying more accessible and affordable care for patients
- Improving health care providers understanding of community needs and culture
- Building capacity of the people and their communities to improve health outcomes
- Providing health education that is targeted to community needs
- Strengthening care
- Contributing to the continuity and coordination of care
- Improving self-management of care between physician visits
- Providing direct health care services, such as basic first aid and conducting health screenings
- Assisting patients with attending appointments and adhering to medication regimens
CHWs and the HIV Care Continuum
The HIV Care Continuum outlines the stages of care a person diagnosed with HIV should go through to achieve viral suppression, beginning with testing and diagnosis, followed by getting and staying in medical care, receiving antiretroviral therapy (ART), and achieving viral suppression. Unfortunately, individuals with HIV face many obstacles that prevent them from obtaining the necessary care to diagnose and manage HIV, resulting in poor health outcomes.
Health care teams can utilize CHWs in each of the stages of HIV care:
- Testing & Diagnosis
- Identify testing locations and resources
- Educate patients on HIV prevention
- Provide social and emotional support for newly diagnosed patients
- Guide newly diagnosed individuals through the Care Continuum to reach viral suppression
- Engagement in Medical Care
- Coordinate and remind patients of medical appointments
- Follow up with patients after appointments to make sure patient received the care they needed and provide needed support
- Help patients understand instructions from health care provider
- Help identify and address barriers to accessing medical care
- Assist patients in obtaining supportive services (nutrition, housing, mental health services, etc.)
- Help patient understand how to properly administer medication
- Follow up with patient to address medication side effects
- Identify and address challenges to taking medications
- Encourage individuals to remain in care
- Viral Suppression
- Educate individuals on the importance and benefits of achieving viral suppression
- Provide support for self-management
- Encourage individuals to live a healthy lifestyle
CHWs can use their specialized training and personal experience to improve health outcomes for individuals living with HIV, specifically for those in vulnerable communities who are less likely to remain in the care continuum. Together, public health practitioners and Community Health Workers can increase the number of individuals who achieve viral suppression.
CHW Training Certification
Within the south central AETC region, Texas offers a training and certificate program. For more information, please click here. For New Mexico, please click here; for Arkansas, click here; and for Louisiana, click here.
More Information & Additional Resources:
Centers for Disease Control and Prevention [CDC]. (2015 April). Addressing chronic disease through community health workers: A policy brief on community health workers (2nd ed.). Retrieved from https://www.cdc.gov/dhdsp/docs/chw_brief.pdf
Centers for Disease Control and Prevention [CDC]. (2016 May). Using community health workers to enhance the coordination of care and advance health equity. Retrieved from https://www.cdc.gov/nccdphp/dch/pdfs/DCH-CHW-Issue-Brief.pdf