Development of a Paraprofessional Home Visiting Program for Low-Income Mothers and Infants

The Seattle-King County healthy homes project: implementation of a comprehensive approach to improving indoor environmental quality for low-income children with asthma.

“…They included being outgoing and skilled at establishing rapport with diverse participants, being nonjudgmental in their relationships with their clients, having an ability to adapt to changing job requirements, being able to set priorities independently in the context of a carefully defined weekly work plan, having flexibility to work evenings and weekends, being able to learn new skills and information and transmit them to their clients, understanding and being comfortable with their clients and communities, being good communicators, being caring and respectful, connecting well with clients in their cultural context, knowing their communities and being involved in them as volunteers and members of social networks, having good organizational skills and paying attention to details (e.g., reporting and documentation, scheduling), being motivated to help others, being reliable with good follow-through and selfmanagement, and having lots of energy, enthusiasm, patience and perseverance. These attributes of successful community health workers are similar to those described by other projects (76,77,130).…”

“…The CHES had characteristics that allowed them to bridge the gap between community members and health agencies and institutions: connection to and understanding of the community; shared ethnic, linguistic, and cultural background with project participants; and recognition as a person who can be respected and trusted (75)(76)(77)(78). Six CHES (including their coordinator) worked for the project over the course of its 4 years, with one or two full-time workers and their coordinator providing services at any one time.…”

Roles and Functions of Community Health Workers in Primary Care

“…Advocates on behalf of patients by serving as "culture brokers" 50 Provides emotional support, validates patients' feelings, asks open-ended questions, and listens reflectively 39 Leads walking club and assists with group peer support meetings focused on coping with life with chronic disease, stress management, group empowerment, and other group-selected activities 38 Health assessment Performs clinical assessments within or outside of clinic appointments…”

“…Based on the distribution of CHW-PC functions across studies, k-means clustering indicated 3 clusters (average silhouette width = 0.23, SD = 0.7). Removing 6 studies with MMAT quality scores <50% 21,22,28,40,46,50 had little impact on clusters (average silhouette width = 0.22, SD = 0.05). We labeled clusters as CHW-PC roles having similar constellations of functions: clinical services, community resource connections, and health education and coaching ( Table 2).…”

“…37 Health Education and Coaching Health education and coaching are key functions of the third role. 20,[41][42][43][44][45][46][47][48][49][50] Health coaching generally involved motivational interviewing 46 and action planning to help patients achieve health goals. 45 Health education typically targeted specific issues, such as cancer screening 42,44 or self-management of a chronic illness.…”