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Addressing Social Determinants of Health through Community Health Workers: A Call to Action
https://hispanichealthcouncil.org/images/Brief2018.pdf
Date: 2018
Pages: 22
Authors: Hispanic Health Council
PROJECT DIRECTOR
Grace Damio Director of Research and Training Hispanic Health Council
COLLABORATORS
PROJECT ADVISORS
WORKER POLICY RESEARCH EXPERT PANEL
The Hispanic Health Council and its expert policy research panel developed a total of 20 recommendations in seven broad CHW policy categories, as listed below:
Payment of Community Health Worker Services Recommendations:
Community Health Worker Caseloads Recommendations:
Community Health Worker Training Recommendations:
Reflective and Trauma-Informed Mentoring and Supportive Supervision of Community Health Workers Recommendations:
Integration of Community Health Workers into Care Teams Recommendations:
Documenting the Effects of Community Health Worker Services on Social Determinants of Health Recommendations:
CHW Common Indicators Project
Goal: In partnership with and building on work begun by Dr. Edith Kieffer and Gloria Palmisano of the Michigan CHW Alliance (MiCHWA), the CHW Common Indicator Project, are attempting to identify common process and outcome indicators for CHW practice.
Jan 11 2017: Over 90 people joined CHW Common Indicators Project for a pre-conference workshop at the Annual Meeting of the American Public Health Association in Denver, Colorado. We gathered additional input on the proposed list of indicators as well as suggestions for tools and scales to measure the indicators.
Executive-Summary_Community-Health-Worker-Common-Indicator-Summit_Final.pdf
Prepared by: Edith Kieffer, Gloria Palmisano, Pei-ru Wang, Leticia Rodriguez Garcia, Kenneth Maes, Caitlin Allen and Noelle Wiggins
Funders: Cambia Health Foundation and Social Venture Partners of Portland, OR.
Pages: 10
Noelle Wiggins, MS, EdD, co-principal investigator for the CHW Common Indicators Project, was the lead author on the Roles and Competencies chapter of the 1998 National Community Health Advisor (NCHA) Study. She came to the CHW/P community as a researcher and an advocate.
Why CHW indicators are needed
The summit, which was held in Portland, OR, on October 2-3, 2015, brought together 16 CHWs, researchers and evaluators, and program staff from five states.
Proposed Process Indicators:
1. Workforce capacitation/support (level of CHW)
a. Involvement of CHWs in decision making process
b. Level of social support the organization provides for the CHW
c. Value of CHW to the organization and acceptance of CHW
2. Frequency of enactment of 10 core roles (level of community member/participant/client)
3. Trust/satisfaction with CHW relationship (level of community member/participant/client)
4. Referrals made (level of community member/participant/client) a. CHW facilitated connections at all levels b. Connections to resources, organizations, and policy makers (level of systems)
5. The extent to which CHWs are part of the policy-making process
a. CHWs teaming with systems, organizations and policy making bodies
b. Degree are CHWs are integrated into health care teams
Proposed Outcome Indicators
1. CHW satisfaction with their job
2. Participant food, water, transportation, and security
3. Participant access to health and social services
4. Participant knowledge, attitudes and behaviors
5. Participant social support
Community Health Workers and the Power of Measurement
By Keara Rodela on May 12, 2020
Table 1. Evaluation constructs co-identified by CHWs and other evaluation experts
(See above)
How should community health worker (CHW) programs be evaluated? A collaborative team recently published an important article advancing an answer to this pressing question, focused on CHW programs in low- and middle-income countries. Here, we provide a complementary answer to this question, advanced by the CHW Common Indicators Project (CI Project), which aims to identify and recommend a set of evaluation indicators to systematically assess the work and impacts of CHWs in the USA. The CI Project’s long-term objective is nationwide adoption of these indicators and development of infrastructure to collect data and report results, with the ultimate goal of optimizing CHW contributions through standardized monitoring and quality improvement, while centering CHWs as experts and leaders.
A conceptual framework for measuring community health workforce performance within primary health care systems
Human Resources for Health volume 17, Article number: 86 (2019) Cite this article
Abstract
Background
With the 40th anniversary of the Declaration of Alma-Ata, a global effort is underway to re-focus on strengthening primary health care systems, with emphasis on leveraging community health workers (CHWs) towards the goal of achieving universal health coverage for all. Institutionalizing effective, sustainable community health systems is currently limited by a lack of standard metrics for measuring CHW performance and the systems they work within. Developed through iterative consultations, supported by the Bill & Melinda Gates Foundation and in partnership with USAID and UNICEF, this paper details a framework, list of indicators, and measurement considerations for monitoring CHW performance in low- and middle-income countries.
Methods
A review of peer-reviewed articles, reports, and global data collection tools was conducted to identify key measurement domains in monitoring CHW performance. Three consultations were successively convened with global stakeholders, community health implementers, advocates, measurement experts, and Ministry of Health representatives using a modified Delphi approach to build consensus on priority indicators. During this process, a structured, web-based survey was administered to identify the importance and value of specific measurement domains, sub-domains, and indicators determined through the literature reviews and initial stakeholder consultations. Indicators with more than 75% support from participants were further refined with expert qualitative input.
Results
Twenty-one sub-domains for measurement were identified including measurement of incentives for CHWs, supervision and performance appraisal, data use, data reporting, service delivery, quality of services, CHW absenteeism and attrition, community use of services, experience of services, referral/counter-referral, credibility/trust, and programmatic costs. Forty-six indicators were agreed upon to measure the sub-domains. In the absence of complete population enumeration and digitized health information systems, the quality of metrics to monitor CHW programs is limited.
Conclusions
Better data collection approaches at the community level are needed to strengthen management of CHW programs and community health systems. The proposed list of metrics balances exhaustive and pragmatic measurement of CHW performance within primary healthcare systems. Adoption of the proposed framework and associated indicators by CHW program implementors may improve programmatic effectiveness, strengthen their accountability to national community health systems, drive programmatic quality improvement, and plausibly improve the impact of these programs.
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International Perspective:
A conceptual framework for measuring community health workforce performance within primary health care systems.
Authors: Agarwal, S., Sripad, P., Johnson, C. et al.
Hum Resour Health 17, 86 (2019). https://doi.org/10.1186/s12960-019-0422-0
Published 20 November 2019
DOIhttps://doi.org/10.1186/s12960-019-0422-0
Author: NACHW
Pages: 6
Date: March 1, 2021
Sections:
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It is with great excitement that we share with you all the NACHW National Policy Platform. This document is an important tool to promote national professional identity, leadership and capacity of CHWs and our Associations.
This document was created over the past year of town hall calls with over 30 CHW Associations, 3 national CHW polls, numerous partner meetings, member input on the Biden administration's national plan to Build Back Better and in consultation with many of you. It centers many of the policies and best practices that are already nationally endorsed within our field and can be applied to COVID-19 response efforts as well as long term policy development.
Likely there are things we will add to this document as we learn! However, now is the time for us to come together as CHWs and allies to articulate to public and private institutions our values and strategies to Respect, Protect and Partner with us.
Over the next few weeks, NACHW will begin to share this document widely, in presentations, on social media, through our newsletter, etc. if you have an upcoming presentation, we would be happy to provide you with slides to share these policy recommendations and more about NACHW.
Thank you again for your expertise, contributions and partnership. I honor your voices and look forward to continued advancement of CHWs through our unity.
Many thanks!
Denise Octavia Smith, MBA, CHW, PN
Executive Director
This is the nation’s largest searchable collection of documents on policies around CHWs (mainly on the state level).
Documents found in this resource center are most useful for: state government officials; CHW leaders; current and potential employers and payers for CHWs; other individuals and stakeholder organizations involved in considering policies on CHWs This database is not a resource for individual CHWs looking for tools to inform or improve their practice.
The current document collection focuses on four main topic areas:
The main use of this resource center is to find information on the process other states have gone through in advancing policies around CHWs.
This can help you understand policy options available to your state, or to learn about experiences in other states who have pursued policies or investments similar to ones you are considering for your state.
Date August 2013
Pages 24
Contact: For more information, please contact: Kevin Barnett, Dr.P.H., M.C.P., Senior Investigator, Public Health Institute, and Co-Director, California Health Workforce Alliance (www.calhealthworkforce.org), at kevinpb@pacbell.net
PROJECT LEADERSHIP TEAM (pg 22)
Steve Barrow CEO and President AHEAD
Juan Carlos Belliard, Ph.D. Assistant Vice President for Community Partnerships and Diversity Loma Linda University
America Bracho, MD Executive Director Latino Health Access
Xochitl Castaneda Director Health Initiative of the Americas,
UC Berkeley, School of Public Health
Cecilia Echeverría, MPP, MPH Director of Safety Net Partnerships Kaiser Permanente
Catherine Dower, JD Associate Director Center for the Health Professions, University of California, San Francisco
Pamela Ford-Keach, MS California Department of Public Health
Nancy Halpern Ibrahim, MPH Executive Director Esperanza Community Housing Corporation
Maria Lemus Executive Director Vision y Compromiso
Laura Long, MBA Director of National Workforce Planning and Development, Kaiser Permanente
Jean Nudelman, MPH, Director of Community Benefit Programs, Kaiser Permanente
David Quackenbush, Vice President of Member Services, California Primary Care Association
Rea Pañares, MHS ;Senior Advisor, Prevention Institute
Beatriz Solis, Ph.D., MPH, Director of Healthy Communities, Strategies South Region, The California Endowment
Perfecto Munoz, Senior Policy Advisor on Consumer Health and the Workforce, UC Berkeley, School of Public Health
Tivo Rojas-Cheatham, MPH, Chief of the Community Participation and Education Section, CDPH
COMMUNITY HEALTH WORKERS IN CALIFORNIA: Sharpening Our Focus on Strategies to Expand Engagement
Date: January 2015
Pages: 33
http://www.phi.org/uploads/application/files/2rapr38zarzdgvycgqnizf7o8ftv03ie3mdnioede1ou6s1cv3.pdf
CONTENTS Acknowledgements..............................................................................................................................2
Executive Summary..............................................................................................................................3 Introduction ..........................................................................................................................................6 Background ...........................................................................................................................................8 Discussion Themes Design Considerations in Team-Based Care..................................................17
Skills, Recruitment, and Training of CHWs.......................................................................................20
Organizational Capacity for Engagement .......................................................................................23
Building Analytic Capacity .................................................................................................................25
Taking the Engagement of CHWs to Scale: Recommendations....................................................30
Appendix A..........................................................................................................................................33
R1: Establish a statewide clearinghouse to facilitate the rapid sharing of innovations, tools, best practice delivery models, and research support resources.
R2: Develop a landscape analysis that outlines a scope of practice for CHWs that accommodates alternative team-based models and other team members and the full range of services and activities in clinical and community-based settings.
R3: Conduct an independent assessment of employer-based, independent, and academic institution-based training programs that describes content scope and intensity, time frame, prerequisites, pedagogical models, geographic focus, and competencies.
R4: Develop competency-based certification standards for new and existing training programs and for individuals who complete the appropriate training.
R5: Identify regional sites to pilot the establishment of centralized data repositories that facilitate the integration of community-level data collection efforts and support the expanded use of collaborative data sharing tools for patient care management.
R6: Provide targeted technical assistance to community health clinics to develop or adapt existing evaluation tools to monitor and disseminate program outcomes.
R7: Partner with mobile health technology organizations to support mobile data collection, point of care decision support, and case management by CHWs and pilot those interventions with selected communities and organizations.
R8: Develop standard metrics that effectively capture outcomes associated with services and activities undertaken by CHWs to address the social determinants of health.