Health Education Homework
ned.kh
ph_484_chapter_7-_2015.pptxChapter 7
Capacity Building and the Role of Community Health Workers
Community Capacity Community Empowerment
Community Capacity / The development of the skills, knowledge and infrastructure to effectively promote health, prevent disease, improve the quality of life and engage local communities in self-determined activities for desired change to an undesirable social condition
Community Empowerment / The process by which communities increase their assets and attributes and build capacity to increase access, partners, networks and a voice in order to gain control over the factors and decisions that shape their lives
(These two concepts can overlap)
The Public Health Role of Community Based Organizations (CBOs)
Community Based Organizations are:
Considered a basic component of the public health infrastructure
A Core component of national strategies to disease prevention and other health challenges
Key in helping public health professionals to better understand social, behavioral and other community determinants of health and provide guidance for local community disease-prevention activities
The Capacity of CBOs: The Presumed Role of Community Members
Many CBOs lack the capacity to plan, implement and evaluate appropriate community interventions
Most CBOs have not developed beyond a foundational infrastructure of coalition building, general planning and limited action plan development
Perceived as limited or undetermined effectiveness
Much work is needed to increase their capacity for program effectiveness
The Role of CHWs
Primarily lay people
Trained to deliver health care information
Trained to provide social support & advice
Advocates who bridge social & cultural gaps between the community they serve and providers of health and social services
They provide culturally relevant education, counseling, social support and may be trained to deliver some basic clinical support services
The Community Action Model
The Community Health Worker (CHW) and Community Engagement
Community Engagement / A community-wide process by which organizations, individuals and institutions are mobilized to identify challenges, and propose and execute solutions to their common concerns
CHWs should have involvement in every phase of the community engagement process
The Cycle of Community Engagement: Coming Together (Planning); Moving Forward (engagement); Sustaining momentum (evaluation and feedback)
The purpose of the document in the link below is to show a commitment to actively engaging the community in decision making activities of Council. The document outlines an understanding of community engagement, along with the aim and objectives that will enable Council to engage more effectively with the community.
Community Engagement Model Example
Core Competencies and Training Issues for CHWs
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Retrieved on August 1, 2013 http://www.machw.org/documents/CHWInitiative10CHWCoreCompetencies10.17.07.pdf
CHWs as Social Capital: A Theoretical Framework of Capacity Building
Social Capital / Relationships & structures enabling the community to experience productive benefits.
Social Cohesion / The bond that brings people together
Social networks / The structure set up for communications and interactions within a community
CHWs are a critical component of social capital. Social capital is a key component of community capacity building
THEORIES APPLIED TO CHWs WORK OF CAPACITY BUILDING
Health Belief Model / Perceived severity, vulnerability, self-efficacy, benefits, barriers and cues to action
Self-Determination / Based on autonomous self-regulation and perceived competence
Transtheoretical Model / The cornerstone of the work that is performed by CHWs. Five stages of change that individuals move through: Precontemplation, Contemplation, preparation, action, maintenance
Self-Efficacy / An individual’s confidence in the ability to change will influence the behavior the individual actually engages in
Locus of control / An individual’s expectations concerning where control over events resides
Conceptual Model: Social capital and capacity building through the use of community health workers
Education
Resources
Support
Behavioral Change
Social Cohesion
& Social Networks
Healthy Community
Community Capacity Building
Policy Change Community Intervention
Trained Community Health Workers
Social Capital
Health Beliefs
Empowerment
Motivation
Build Relationships and Develop Trust
CHWs & Community Member Interaction
1) Outreach Methods and Strategies
CHWs must be involved in on-going outreach efforts by first and foremost “meeting people
where they are.” Outreach is the provision of health-related information and services to a
population that traditionally has not been served and/or been underserved. CHWS must use
outreach strategies and methods to bring servic es to where a population (or group) resides and
works, and at community sites such as street corners, grocery stores, community parks. They
support community people in finding and using resources and assist in creating and supporting
connections among community members and caregivers.
2) Client and Community Assessment
CHWs must make on-going efforts to identify co mmunity and individual needs, concerns and
assets. They must draw upon standard knowledge of basic health a nd social indicators to define
needs clearly. They must effectively engage cl ients and/or their families in on -going assessment
efforts. As part of the outreach planni ng process, community assessment informs the
development of an outreach plan and stra tegy for a target population or community.
3) Effective Communication
CHWs must communicate effectivel y with clients about individual needs, concerns and assets.
They must convey knowledge of basic health and social indicators clearly and in culturally
appropriate ways. They must also communicat e with other community health workers and
professionals in ways that use appropriat e terms and concepts in accessible ways.
4) Culturally Based Communication and C are
CHWs must be able to use rele vant languages, respectful attitude s and demonstrate deep cultural
knowledge in all aspects of their work with i ndividuals, their families, community members and
colleagues. They must convey standard knowledge of basic health and social concerns in ways
that are familiar to clients and their families. Especially when challenging what might be
“traditional” patterns of behavior, CHWs must be able to discuss the reasons and options for
change in culturally sensitive ways. Effective cross cultural communication is an ever deepening
central aspect of CHW practice in all areas.
5) Health Education for Behavior Change
CHWs must make on-going efforts to assist individuals and their families in making desired
behavioral changes. They must use standard knowledge of the effects of positive and negative
behaviors in order to assist clients in adop ting behaviors that are mutually acceptable and
understood by families and community contacts. They must effectively engage clients and/or
their families in following intervention prot ocols and in identifying barriers to change.
6) Support, Advocate and Coor dinate Care for Clients
In addition to helping individuals,
CHWs must advocate for and coordi nate care for their clients.
They must be familiar with and maintain cont act with agencies and professionals in the
community in order to secure need ed care for their clients. They must effectively engage others
in building a network of community and profe ssion support for their clients. They should
participate in community and agency planning a nd evaluation efforts that are aimed at improving
care and bringing needed services into the community.
7) Apply Public Health Concepts and Approaches
CHWS must see their work as one part of the broader context of public health practice. An
understanding the bigger picture of the basic principles of public he alth allows CHWs to assist
individuals, families communities in understand ing the basic role of prevention, education,
advocacy and community participation in their care. Knowing the critical importance of effective
community care allows community health workers to find pride a nd power in their roles and in
advocating for their own need s, as well as those of others.
8) Community Capacity Building
CHWs play a critical role in increasing the abil ities of their communities to care for themselves.
They must work together with other community members, workers and professionals to develop
collective plans to increase resources in their commun ity and to expand broader public
awareness of community needs.
9) Writing and Technical Communication Skills
CHWs are required to wri te and prepare clear reports on their clients, their own activities and
their assessments of individual a nd community needs. Over time they are also expected to make
statements and give presentations regarding the needs and concerns of their clients t o other
workers and agency professionals. Doing so de pends upon the ability to read and write in
English and to use technology effectively. Wr iting and technical communication skills are
expected to increase with experience, so that on-going progress is an expected aspect of
competence.
10) Special Topics in Community Health
In addition to the general competencies above , an effective CHW will also be able to
demonstrate knowledge regarding a variety of speci al topics and appropriate models of practice
applicable to such topics. There are many po ssible competencies possible under this category.
Training regarding several of them may be availabl e from a variety of providers, in addition to
CHEC.
Last Edited on 10/16/07
