Video Spotlight

"'I'm a Health Worker' - Abduaraman Gidi" made by IntraHealth International.

The role of community health workers (CHWs) in health promotion research: ethical challenges and practical solutions.

This article aims to describe the role of community health workers (CHWs) in health promotion research and address the challenges and ethical concerns associated with this research approach. Findings reveal a number of challenges that investigators and project managers encounter when working with CHWs on research projects involving the community.

5-SPICE: the application of an original framework for community health worker program design, quality improvement and research agenda setting

Despite decades of experience with community health workers (CHWs) in a wide variety of global health projects, there is no established conceptual framework that structures how implementers and researchers can understand, study and improve their respective programs based on lessons learned by other CHW programs. Engaging a large group of implementers, researchers and the best available literature, the 5-SPICE framework was refined and then applied to a selection of CHW programs. Insights gleaned from the case study method were summarized in a tabular format named the ‘5x5-SPICE chart’.

Cultural translation of interventions: diabetes care in American Samoa.

Translation of research advances into clinical practice for at-risk communities is important to eliminate disease disparities. Adult type 2 diabetes prevalence in the US territory of American Samoa is 21.5%, but little intervention research has been carried out there. We discuss our experience with cultural translation, drawing on an emerging implementation science, which aims to build a knowledge base on adapting interventions to real-world settings.

Indicator Guide: Monitoring and Evaluating Integrated Community Case Management

This guide aims to encourage integrated Community Case Management (iCCM) programs to more effectively monitor and evaluate iCCM implementation and results across all of the iCCM benchmark components. Aimed at program managers, M&E officers, researchers, and organizations supporting/implementing iCCM, specific objectives of this guide are to:

Community-based Validation of Assessment of Newborn Illnesses by trained Community Health Workers in Sylhet district of Bangladesh

This article attempts to validate trained community health workers' (CHWs') recognition of signs and symptoms of newborn illnesses and classification of illnesses using a clinical algorithm during routine home visits in rural Bangladesh. Between August 2005 and May 2006, 288 newborns were assessed independently by a CHW and a study physician. Based on a 20-sign algorithm, sick neonates were classified as having very severe disease (VSD), possible very severe disease (PVSD) or no disease.

Best Practice Guidelines for Implementing and Evaluating Community Health Worker Programs in Health Care Settings

There is a growing movement among health care organizations to adopt the Community Health Worker (CHW) model into their system as a way to provide comprehensive care to patients and community members. At the same time there is uncertainty about how to implement the CHW model to achieve better patient outcomes, higher quality of care, and lower health care costs. With generous funding from the Lloyd A.

Comprehensive asthma management for underserved children.

In response to the 'asthma epidemic', local organisations in San Francisco formed the Yes We Can Urban Asthma Partnership, which uses a comprehensive medical/social model for paediatric asthma care. The Yes We Can Urban Asthma Partnership reaches out to high-risk children in different clinical settings: urgent visits, the hospital, a comprehensive specialty asthma clinic, and through an expanded community health worker programme.

Promotoras as Mental Health Practitioners in Primary Care: A Multi-Method Study of an Intervention to Address Contextual Sources of Depression

We assessed the role of promotoras—briefly trained community health workers—in depression care at community health centers. The intervention focused on four contextual sources of depression in underserved, low-income communities: underemployment, inadequate housing, food insecurity, and violence. After a structured training program, primary care practitioners (PCPs) and promotoras collaboratively followed a clinical algorithm in which PCPs prescribed medications and/or arranged consultations by mental health professionals and promotoras addressed the contextual sources of depression.

Peer-led diabetes education programs in high-risk Mexican Americans improve glycemic control compared with standard approaches: a Project Dulce promotora randomized trial.

This research was designed to evaluate the effect of a culturally sensitive diabetes self-management education program that uses a low-cost, peer-educator format (Project Dulce) on glucose control and metabolic parameters in low-income Mexican Americans with type 2 diabetes. This randomized trial, using the Project Dulce model of culturally sensitive, peer-led education, demonstrates improvement in glucose and metabolic control and suggests that this low-cost approach to self-management education for high-risk diabetic populations is effective.

The impact of community health worker training and programs in NYC.

The Northern Manhattan Community Voices Collaborative is committed to improving health care in Harlem, Washington Heights, Inwood, and low-income communities in New York City, large parts of which are home to many immigrants to the U.S. The collaborative developed a program to train and integrate community health workers (CHWs) into ongoing programs at partner community organizations. We report on our 2000-2005 experiences with CHWs for health insurance, child immunizations, and asthma management.

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