Increasingly, CHWs are being hired by clinic systems, community mental health centers, federally-qualified health centers and local public health agencies to strengthen team-based services to patients and families. CHWs reduce demand on overburdened providers by promoting healthy behaviors and helping patients understand how to access and use care appropriately.
For example, in one recent clinical trial, CHWs worked with patients to create individualized action plans for achieving patients’ stated goals for post-hospital recovery. The CHWs provided support tailored to patient goals for a minimum of two weeks to determine whether a tailored community health worker (CHW) intervention would improve posthospital outcomes among low-SES patients. As reported in JAMA Internal Medicine, the trial showed that patient-centered CHW intervention improves access to primary care and quality of discharge while controlling recurrent readmissions in a high-risk population.
Other examples can be found in rural Ely, Minn., where two innovative initiatives have led to improved health outcomes for patients with complex chronic conditions, as described in Collaborating on Mental Health: Patient Outcomes Improved by Creative Partnership (page 22), published in Minnesota Physician.
Additional evidence for the effectiveness of peer health navigation intervention for improving health and healthcare utilization is documented in A Pilot Test of a Peer Navigator Intervention for Improving the Health of Individuals with Serious Mental Illness, in Community Mental Health Journal, May 2014 (subscription needed to access article). In the pilot, participants receiving intervention experienced fewer pain and health symptoms, and also changed their orientation about seeking care to a primary care provider rather than the emergency room.
Along similar lines, promotora interventions are increasingly recognized for their health education capacity in addition to the unique ability of promotoras to serve as “bridges” between community members and health care providers. One example can be found in Results from a Pilot Promotora Program to Reduce Depression and Stress among Immigrant Latinas, which describes the evaluation of a pilot promotora intervention offered in three North Carolina counties to improve mental health among Latinas. Participants in this intervention reported lower levels of perceived stress and acculturation stress, as well as significant changes in the levels of depressive symptoms, with an 8 point decrease from mean at post-test (50% reduction, p<.01).