Promoting Hispanic Immigrant Health via Community Health Workers and Motivational Interviewing

Abstract

Hispanic immigrant health disparities are among the highest in the nation, especially related to obesity and access to health services. Healthy Fit (En Forma Saludable) is a health promotion program that leverages public health department infrastructure to address these disparities through the use of three key innovations explored in this article: community health workers (CHWs), motivational interviewing (MI), and vouchers for free preventative health services. CHWs trained in MI conduct a health screening and then distribute preventive service vouchers and health resources as needed based on screening results. Vouchers cover breast, cervical, and colorectal cancer screening, and several vaccinations including flu and human papillomavirus. Resources to support exercise, to support a healthy diet, to quit smoking, and to reduce risky drinking are also distributed as needed. CHWs then use MI to address perceived barriers and strengthen intrinsic motivation to make use of the health resources. Integrating these strategies provides a low-cost approach to promote healthy behavior in an underserved immigrant population.

A Review of Community Health Worker Integration in Health Departments

“…The program contributed to fewer emergency department (ED) visits and lower ED visit costs [ 23 ]. In Texas, the City of El Paso Department of Public Health partnered with a university to create a CHW program called Healthy Fit, which aimed to reduce Hispanic health inequities [ 24 , 25 ]. CHWs screened participants, provided vouchers for health resources, and conducted motivational interviews to further support participants [ 25 ].…”

“…In Texas, the City of El Paso Department of Public Health partnered with a university to create a CHW program called Healthy Fit, which aimed to reduce Hispanic health inequities [ 24 , 25 ]. CHWs screened participants, provided vouchers for health resources, and conducted motivational interviews to further support participants [ 25 ]. Healthy Fit ultimately helped increase cancer screenings and immunizations in the community, recruiting over 2500 participants [ 25 ].…”

“…CHWs screened participants, provided vouchers for health resources, and conducted motivational interviews to further support participants [ 25 ]. Healthy Fit ultimately helped increase cancer screenings and immunizations in the community, recruiting over 2500 participants [ 25 ].…”

Addressing Hispanic Obesity Disparities Using a Community Health Worker Model Grounded in Motivational Interviewing

“…CHWs trained in MI may be able to reach a large percentage of the population with a low-cost intervention like Healthy Fit. 43 The combination of CHWs and MI allows for seamless cultural tailoring of the intervention, given that CHWs are from the community they are trying to reach. 9 MI treats the interviewee as the expert, thereby responding to their own unique situation and culture.…”

Evaluating the Dissemination and Implementation of a Community Health Worker-Based Community Wide Campaign to Improve Fruit and Vegetable Intake and Physical Activity among Latinos along the U.S.-Mexico Border

“…Past research suggests that multimodal CWC models are effective for dissemination and implementation in communities with high needs [79]; our study results corroborated this finding particularly, as increasing exposure to TSSC program modalities, beyond just CHW home visits, were also independently associated with increased FV consumption and PA engagement. CHW Motivational Interviewing training is noted to be rarely done in practice [80] but has been effective in delivering healthy dietary and PA behavior change to border Latinos [55]. Future interventions in Latino communities can incorporate systematic training of Motivational Interviewing for CHWs to empower them to provide more effective health services given their critical liaison role of providing services for low-income Latinos [55,80].…”