Last data update: Jun 17, 2024. (Total: 47034 publications since 2009)
Records 1-8 (of 8 Records) |
Query Trace: Brownstein JN [original query] |
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Community health workers "101" for primary care providers and other stakeholders in health care systems
Brownstein JN , Hirsch GR , Rosenthal EL , Rush CH . J Ambul Care Manage 2023 46 (4) 315-325 Today's ambulatory care providers face numerous challenges as they try to practice efficient, patient-centered medicine. This article explains how community health workers (CHWs) can be engaged to address many patient- and system-related barriers currently experienced in ambulatory care practices. Community health workers are frontline public health workers who serve as a trusted bridge between community members and health care providers. Among their varied roles, CHWs can educate and support patients in managing their risk factors and diseases and link these patients to needed resources. As shown in this overview (CHW 101), including CHWs as members of multidisciplinary care teams has the potential to strengthen both current and emerging models of health care delivery. |
Time-to-treatment for myocardial infarction: Barriers and facilitators perceived by American Indians in three regions
Nesoff ED , Brownstein JN , Veazie M , O'Leary M , Brody EA . J Community Health 2016 42 (1) 129-138 Early recognition of acute myocardial infarction (MI), followed by prompt emergency care, improves patient outcomes. Among rural American Indian (AI) populations there are disparities in access to care for MI and processes of care, resulting in poor MI-related health outcomes compared to the general population. We sought to gain an understanding of barriers related to MI time-to-treatment delays using a qualitative approach. We conducted semi-structured interviews and focus groups with AI key informants and community members in three Indian Health Service regions. Major barriers to care included long travel distance to care and lack of supporting infrastructure; distrust of the health care system; low overall literacy and basic health literacy; priority of family care-giving; and lack of specialized medical facilities and specialists. Findings suggest that improved time-to-treatment facilitators include educating the local community about the causes and consequences of MI and culturally-sensitive health communication, as well as addressing the quality of local systems of care and the community's perception of these systems. Pursuing these strategies may improve quality of care and reduce MI-related morbidity and mortality in rural AI populations. |
Do state community health worker laws align with best available evidence?
Barbero C , Gilchrist S , Chriqui JF , Martin MA , Wennerstrom A , VanderVeur J , Prewitt K , Brownstein JN . J Community Health 2015 41 (2) 315-25 Community health workers (CHWs) are expected to improve patient care and population health while reducing health care costs. Law is a tool states are using to build a supportive infrastructure for the CHW workforce. This study assessed the extent existing state law pertaining to the CHW workforce aligned with best available evidence. We used the previously developed Quality and Impact of Component (QuIC) Evidence Assessment method to identify and prioritize those components that could comprise an evidence-informed CHW policy at the state level. We next assessed the extent codified statutes and regulations in effect as of December 31, 2014 for the 50 states and D.C. included the components identified in the evidence assessment. Fourteen components of an evidence-informed CHW policy were identified; eight had best, three had promising, and three had emerging evidence bases. Codified law in 18 states (35.3 % of 51) pertained to the CHW workforce. Fifteen of these 18 states authorized at least one of the 14 components from the evidence assessment (maximum: nine components, median: 2.5). The most frequently authorized component was a defined scope of practice for CHWs (authorized by eight states) followed by a standard core competency curriculum and inclusion of CHWs in multidisciplinary health care teams (each authorized by six states). States could consider the components presented in this article when developing new or strengthening existing law. |
Strengthening the effectiveness of state-level community health worker initiatives through ambulatory care partnerships
Allen C , Brownstein JN , Jayapaul-Philip B , Matos S , Mirambeau A . J Ambul Care Manage 2015 38 (3) 254-62 The transformation of the US health care system and the recognition of the effectiveness of community health workers (CHWs) have accelerated national, state, and local efforts to engage CHWs in the support of vulnerable populations. Much can be learned about how to successfully integrate CHWs into health care teams, how to maximize their impact on chronic disease self-management, and how to strengthen their role as emissaries between clinical services and community resources; we share examples of effective strategies. Ambulatory care staff members are key partners in statewide initiatives to build and sustain the CHW workforce and reduce health disparities. |
Community health workers as an integral strategy in the REACH U.S. program to eliminate health inequities
Cosgrove S , Moore-Monroy M , Jenkins C , Castillo SR , Williams C , Parris E , Tran JH , Rivera MD , Brownstein JN . Health Promot Pract 2014 15 (6) 795-802 Mounting evidence indicates that community health workers (CHWs) contribute to improved behavioral and health outcomes and reductions in health disparities. We provide an overview (based on grantee reports and community action plans) that describe CHW contributions to 22 Racial and Ethnic Approaches to Community Health (REACH) programs funded by the Centers for Disease Control and Prevention from 2007 to 2012, offering additional evidence of their contributions to the effectiveness of community public health programs. We then highlight how CHWs helped deliver REACH U.S. community interventions to meet differing needs across communities to bridge the gap between health care services and community members, build community and individual capacity to plan and implement interventions addressing multiple chronic health conditions, and meet community needs in a culturally appropriate manner. The experience, skills, and success gained by CHWs participating in the REACH U.S. program have fostered important individual community-level changes geared to increase health equity. Finally, we underscore the importance of CHWs being embedded within these communities and the flexibility they offer to intervention strategies, both of which are characteristics critical to meeting needs of communities experiencing health disparities. CHWs served a vital role in facilitating and leading changes and will continue to do so. |
Community health workers can be a public health force for change in the United States: three actions for a new paradigm
Balcazar H , Rosenthal EL , Brownstein JN , Rush CH , Matos S , Hernandez L . Am J Public Health 2011 101 (12) 2199-203 Community health workers (CHWs) have gained increased visibility in the United States. We discuss how to strengthen the roles of CHWs to enable them to become collaborative leaders in dramatically changing health care from "sickness care" systems to systems that provide comprehensive care for individuals and families and support community and tribal wellness. We recommend drawing on the full spectrum of CHWs' roles so that they can make optimal contributions to health systems and the building of community capacity for health and wellness. We also urge that CHWs be integrated into "community health teams" as part of "medical homes" and that evaluation frameworks be improved to better measure community wellness and systems change. (Am J Public Health. Published online ahead of print October 20, 2011: e1-e5. doi:10.2105/AJPH.2011.300386). |
Community health workers "101" for primary care providers and other stakeholders in health care systems
Brownstein JN , Hirsch GR , Rosenthal EL , Rush CH . J Ambul Care Manage 2011 34 (3) 210-20 Today's ambulatory care providers face numerous challenges as they try to practice efficient, patient-centered medicine. This article explains how community health workers (CHWs) can be engaged to address many patient- and system-related barriers currently experienced in ambulatory care practices. Community health workers are frontline public health workers who serve as a trusted bridge between community members and health care providers. Among their varied roles, CHWs can educate and support patients in managing their risk factors and diseases and link these patients to needed resources. As shown in this overview (CHW 101), including CHWs as members of multidisciplinary care teams has the potential to strengthen both current and emerging models of health care delivery. |
A Community Health Advisor Program to reduce cardiovascular risk among rural African-American women
Cornell CE , Littleton MA , Greene PG , Pulley L , Brownstein JN , Sanderson BK , Stalker VG , Matson-Koffman D , Struempler B , Raczynski JM . Health Educ Res 2009 24 (4) 622-33 The Uniontown, Alabama Community Health Project trained and facilitated Community Health Advisors (CHAs) in conducting a theory-based intervention designed to reduce the risk for cardiovascular disease (CVD) among rural African-American women. The multiphased project included formative evaluation and community organization, CHA recruitment and training, community intervention and maintenance. Formative data collected to develop the training, intervention and evaluation methods and materials indicated the need for programs to increase knowledge, skills and resources for changing behaviors that increase the risk of CVD. CHAs worked in partnership with staff to develop, implement, evaluate and maintain strategies to reduce risk for CVD in women and to influence city officials, business owners and community coalitions to facilitate project activities. Process data documented sustained increases in social capital and community capacity to address health-related issues, as well as improvements in the community's physical infrastructure. This project is unique in that it documents that a comprehensive CHA-based intervention for CVD can facilitate wide-reaching changes in capacity to address health issues in a rural community that include improvements in community infrastructure and are sustained beyond the scope of the originally funded intervention. |
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- Page last updated:Jun 17, 2024
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