This pilot study evaluates a community lay health advocate (CLHA) intervention in promoting follow-up for abnormal mammograms among African American women. A controlled trial was implemented at an urban hospital in Atlanta, with 48 women in a CLHA intervention group and 35 in a usual care group. Participants were 25 or older and had an abnormal mammogram between March 25, 2002, and May 2, 2003. Intervention group women received CLHA support including encouragement of timely abnormal mammogram follow-up, reminders of follow-up appointments, identification and removal of barriers to follow-up, and accompaniment to follow-up appointments. Women in the intervention group were significantly more likely to keep their first abnormal mammogram follow-up appointment, all of their scheduled follow-up appointments, and their biopsy or fine needle aspiration appointment. CLHAs are effective in promoting abnormal mammogram followup among African American women and may be an important resource in reducing racial disparities in breast cancer mortality.

In a previous report, we demonstrated the efficacy of an intervention to promote colorectal cancer screening among African Americans in a controlled community intervention trial. Participants in the intervention, named EPICS (Educational Program to Increase Colorectal Cancer Screening), were twice as likely to be screened after six months as those in the control group. In the current project, we put the intervention into practice through an academic‐health department partnership, and the intervention performed as well as it had in the controlled trial. This success may be due to the community‐based participatory methods used in designing and testing the intervention. Clin Trans Sci 2012; Volume 5: 412–415

Background: During the summers of 2016-2019, Morehouse School of Medicine (MSM) with the support of community partners, developed, piloted and implemented an innovative Community Health Worker Training Program for High School students (HSCHW). Training high school community health workers can impact health and social disparities in underserved populations and demonstrates the pipeline of future workers in community health and other health careers. The program has achieved promising outcomes, and access to the program model has been requested by many universities and community-based organizations. Method: The HSCHW training consists of summer classroom instruction, field instruction and monthly continuing education during the school year. The students are trained in CHW core competencies through a combination of online curriculum, interactive classroom experiences, and field activities provided by community partners, multidisciplinary MSM clinical instructors, and graduate student interns. Results: 77 high school students from metropolitan Atlanta High Schools and rural Columbus, GA have been trained as CHWs in the HSCHW program. Students are ages 15-18 and are rising sophomores to recent high school graduates. All participants (100%) were from economically disadvantaged communities. Sixteen school-based and community-based health improvement projects have been developed and implemented by teams of trained HSCHWs. Additionally, over 300 individuals (family and community members) received monthly health monitoring by trained HSCHWs. Conclusions: Overall, the HSCHW program models the engagement of community partners in translational educational initiatives to support community transformation. It can be a giant leap toward improved population health and achieving health equity in underserved communities. It has had a tremendous impact on the youth themselves, their families, and the communities in which they live. In communities with disparate prevalence of chronic disease and unhealthy behaviors, early exposure may mitigate exacerbation or early onset of disease among the participants and their families. High School Community Health Workers are bridges to health equity.

Background: Ample research evidence has demonstrated that Community Health Worker (CHW) programs are a cost-effective, culturally integrated, and impactful way to improve community health. Although most existing CHW programs recruit adults as CHWs, high school students, with their intellectual readiness and intimate community knowledge, also have great potential to be engaged as CHWs that impact community health. With this potential in mind, the High School Community Health Worker Curriculum (HSCHW), for face-to-face training, was created in 2016 at Morehouse School of Medicine (MSM) as an innovative solution to improve community health in underserved, urban neighborhoods. Sixteen Metro Atlanta high school students participated in the program's first cohort. The face-to-face HSCHW training program received very positive feedback from the students and community partners involved. Additionally, during the inaugural training, the program received more than 150 nationwide inquiries about an opportunity to either participate in the program or replicate its curriculum. Hence, in 2018, a corresponding online curriculum was created to meet these needs. The online HSCHW curriculum covers the roles and competencies described in the CHW Core Consensus (C3) Project and focuses on developing high school students' critical thinking, decision-making, and communication skills. As of February 2021, 346 high school community health workers have participated in this online curriculum.Purpose: This paper reports on the research study of the critical processes and strategies of transforming, engaging, and implementing the online HSCHW curriculum.Method: The project team conducted the research study to identify the key strategies to transform the face-to-face HSCHW curriculum, the engagement strategies embedded in the online curriculum's content development, and, ultimately, the curriculum's outcomes. Altogether, this mixed-method study analyzed and reported on the learning outcomes of 265 students', in tandem with 17 high school students' focused-group interviews and responses to online surveys.Results: The results showed that integrating instructional design processes is critical for the online curriculum's success. “Interestingness,” the latent concept embedded in the online HSCHW curriculum, engages high school students in learning about complex CHW skills, through digital content and activities. Furthermore, the successful implementation of the program and its student learning outcomes was assured by integrating the online curriculum with local schools and community resources, training the local community and school “trainers” to facilitate the curriculum online, and providing ongoing coaching support from the program team.Impacts: This paper provides a research report on the key strategies and processes of creating and implementing an online CHW curriculum for high school students. Its findings will inform future endeavors to develop an online CHW curriculum for lifelong learners and increase training effectiveness. The online HSCHW curriculum increases the national capacity of community health workers, whose work will increase community engagement and health equity. The curriculum also empowers high school students to acquire health knowledge that can bridge the educational gap between health knowledge acquisition and health knowledge application. Additionally, the online HSCHW curriculum presents a concrete example of leveraging digital platforms to teach complex public health competencies to young adults who can positively impact community health.

Background: Community Health Workers (CHW) can be an important and evidence-based response to reduce unnecessary morbidity and mortality in chronic diseases like asthma, heart disease, diabetes, cancers, HIV, and maternal/child health, and mental health. Georgia's urban and rural diverse populations are at high risk from many of these conditions. Largely the contributors to the poor outcomes for these health issues are non-medical and include social determinants of health, i.e., access to care, transportation, inadequate housing, and health literacy. CHWs can increase the capacity of individuals, families, and communities to improve their health. Historically, concerns of CHWs on healthcare teams to address these issues have centered on standardized training, credentialing, and challenges about the unique roles and responsibilities of CHWs. In this article, we discuss the evidence of effectiveness and return on investment as CHW interventions prove to reduce visits to the Emergency Departments and unnecessary hospitalizations from chronic diseases. They serve to connect social and medical resources and ensure patients do not fall through gaps, especially among the vulnerable populations. Methods: We conducted a scan of CHW research studies, projects and programs that demonstrate effectiveness and return on investment. We also reviewed CHW efforts in Georgia, timeline, and stakeholders to formally recognize, advance professionalism, and fully integrate CHWs as essential and sustainable members of the healthcare team. Results: There is significant evidence for the effectiveness of CHWs and the cost-benefit of CHW programs. Georgia has ongoing formal efforts to establish a sustainable and well-trained CHW workforce. Conclusions: A well-trained CHW workforce can be an important response to the transformation of Georgia's community health practice and status, decreasing excess morbidity and mortality, and advancing health equity. Georgia should build on its own considerable experience with CHWs and the evidence of effectiveness to adopt policies to fully integrate CHWs into the healthcare system.