Preparing for Community Health Worker Integration Into Clinical Care Teams Through an Understanding of Patient and Community Health Worker Readiness and Intent

Lewis, Charlotte M.; Gamboa-Maldonado, Thelma; Belliard, Juan Carlos; Nelson, Anna; Montgomery, Susanne

doi:10.1097/jac.0000000000000261

Cited by 7 publications

(6 citation statements)

References 24 publications

(29 reference statements)

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“…In the same year, Arizona's CHW workforce gained a substantial policy win through the passage of HB2324, providing the pathway and infrastructure for CHW voluntary certification and mandating CHW-driven workforce standards in training, supervision and career progression (12). While the current policy environment in Arizona is conducive to the integration of CHWs into health systems and clinical care teams, individual and systems-level barriers may hinder the potential for CHW integration to positively impact health outcomes (13)(14)(15).…”

Section: Arizona Contextmentioning

confidence: 99%

Organizational Readiness for Community Health Worker Workforce Integration Among Medicaid Contracted Health Plans and Provider Networks: An Arizona Case Study

Sabo

Wexler

O'Meara

et al. 2021

Front. Public Health

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Understanding and building organizational capacity for system change and the integration of the Community Health Worker (CHW) workforce within the health scare sector requires a supportive organizational culture among sector leaders and providers. The aim of this mixed-methods study was to assess organizational readiness for CHW workforce integration into Arizona Medicaid health systems and care teams. This collaborative effort was in direct response to emergent state and national CHW workforce policy opportunities, and the shifting health care landscape in Arizona – which merged behavior and physical health. Specifically, and in collaboration with a broad-based, statewide CHW workforce coalition, led by the CHW professional association, we assessed 245 licensed health care professionals with experience working with CHWs and 16 Medicaid-contracted health plan leadership. Our goal was to generate a baseline understanding of the knowledge, attitudes and beliefs these stakeholders held about the integration of CHWs into systems and teams. Our findings demonstrate a high level of organizational readiness and action toward integration of CHWs within the Arizona health care system and care teams. CHWs have emerged as a health care workforce able to enhance the patient experience of care, improve population health, reduce cost of care, and improve the experience of providing care among clinicians and staff.

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Section: Arizona Contextmentioning

confidence: 99%

Organizational Readiness for Community Health Worker Workforce Integration Among Medicaid Contracted Health Plans and Provider Networks: An Arizona Case Study

Sabo

Wexler

O'Meara

et al. 2021

Front. Public Health

View full text Add to dashboard Cite

show abstract

“…Meaningful data from the tools used to support CHA infrastructure was utilized in the evaluation to understand the impact of the CHAs in the program. The CHAs begin by engaging with the patient, then, screening for social needs using a social determinants of health screening tool called the Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences (PRAPARE) 8 . From the initiation of engagement, they begin building rapport with the patient as they co-develop a care plan during home visits, or telephonically, to identify the patients' goals and interventions required to achieve these goals.…”

Section: Tools and Infrastructure To Support Cha Integrationmentioning

confidence: 99%

“…CHW/Ps are traditionally managed by community-based organizations or organizations that function as the liaison between health systems and communities (8)(9)(10). With increased financing and delivery of health care services, a recent approach to CHW/Ps as an extension of the clinical system has been introduced that blends these traditional approaches and expands the CHW/P role into healthcare settings.…”

Section: Introductionmentioning

confidence: 99%

Adding a Seat at the Table: A Case Study of the Provider's Perspective on Integrating Community Health Workers at Provider Practices in California

C¹,

Durazo²,

Purry³

et al. 2021

Front. Public Health

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Blue Shield of California's Community Health Advocate Program was created to support whole person-health needs by helping individuals of all socio-economic statuses navigate and access community resources, social services, and medical systems. Blue Shield's Health Reimagined team is partnering with medical providers, community resources centers, and community partners to provide intensive person-centered and technology-enabled care to patients, ensuring social needs are met while promoting health equity. A key aspect of the Health Reimagined initiative embeds Community Health Advocates (CHAs) within physician practices serving patients using a payor-agnostic approach, by which Blue Shield aims to increase access to social services and community resources, improve health outcomes, reduce medical costs, and improve overall patient experience. The purpose of this case study is to understand the provider's perspective of embedding a CHA into the care team and the resulting impact on the practice and patients. Blue Shield also sought to identify best practices and barriers of a CHA program within primary and specialty care practices. As part of an ongoing two-year mixed-methods impact evaluation (2019–2021), 10 semi-structured interviews were conducted with a total of 18 providers and office staff at five primary care and specialty practices where CHAs have been embedded. We also conducted two focus groups with the same five CHAs at different points in time. Several themes emerged from the provider, office staff, and CHA interviews. Provider practices found great value in adding a CHA to their care team as the CHA brings flexibility and continuity to patient care. They also found that having access to a CHA with shared life experiences of the communities they served is a key component to the program's success. Providers and staff reported a new understanding of the social determinants of health that impacts a patient's wellbeing with the embedding of a CHA in the care team. Overall, practitioners expressed high satisfaction with the CHA program. During the COVID-19 pandemic, CHAs have been critically important in care, as social needs have increased, and resources have shifted. The CHA program is constantly adapting to address challenges faced by all stakeholders and applying new knowledge to ensure best practices are implemented within the CHA program.

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“…During the pandemic, they are also part of primary health-care, which is implemented by states and municipalities (Lotta et al , 2020). In the USA, there are three main models for the utilization of community health workers: managed by the community-based, non-profit organizations; managed by organizations of the intersection between health systems and communities; and as extensions of the hospital system (Lewis et al , 2019). …”

Section: Theory and Hypothesismentioning

confidence: 99%

Analyzing a community worker’s stress during the COVID-19 pandemic in China

Gui

Mei

et al. 2021

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Purpose Community governance plays an important role in the prevention and control of the Coronavirus disease 2019 (COVID-19) pandemic in China. Community workers, the main executors in community governance, experience a huge amount of stress, which affects their physical and mental health. Thus, it is crucial to pay more attention to the stressors and stress responses of community workers and propose strategies to alleviate such responses. This paper aims to analyze the work stress of community workers during the COVID-19 pandemic in China. Design/methodology/approach Based on a questionnaire survey of 602 community workers during COVID-19 in China, the four main stressors and 14 stress factors of community workers were identified and six factors at three levels of stress responses were defined. A stress analysis model is proposed that tests the mediating role of psychological capital and the moderating role of organizational climate. Findings The results show that stressors influence stress responses through the moderating role of psychological capital, organizational climate plays a negative mediator role between stressors and psychological capital and the main stressors for community workers are work, safety and performance stress. Originality/value This paper contributes to existing research because it offers suggestions for reducing the impact of stress on the community workers during the COVID-19 pandemic. Further, it can promote the control and prevention of the COVID-19.

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Preparing for Community Health Worker Integration Into Clinical Care Teams Through an Understanding of Patient and Community Health Worker Readiness and Intent

Cited by 7 publications

References 24 publications

Organizational Readiness for Community Health Worker Workforce Integration Among Medicaid Contracted Health Plans and Provider Networks: An Arizona Case Study

Organizational Readiness for Community Health Worker Workforce Integration Among Medicaid Contracted Health Plans and Provider Networks: An Arizona Case Study

Adding a Seat at the Table: A Case Study of the Provider's Perspective on Integrating Community Health Workers at Provider Practices in California

Analyzing a community worker’s stress during the COVID-19 pandemic in China

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