Community Health Workers
About Community Health Workers:
A Community Health Worker is a trusted member or has a good understanding of the community they serve. They are able to build trusting relationships and are able to link individuals with the systems of care in the communities they serve. A CHW also builds individual and community capacity by increasing health knowledge and self-sufficiency through a range of activities such as outreach, community education, informal counseling, social support, and advocacy. CHW is an umbrella term used to define other professional titles.
A Community Health Worker is an individual who:
- Serves as a liaison/link between public health, health care, behavioral health services, social services, and the community to assist individuals and communities in adopting healthy behaviors
- Conducts outreach that promotes and improves individual and community health
- Facilitates access to services, decreases health disparities, and improves the quality and cultural competence of service delivery in Nebraska.
(Information from the American Public Health Association, U.S. Department of Labor, Foundations for Community Health Workers, Berthold, Avila, Miller, August 2009)
Community Health Worker Videos:
The Nebraska Department of Health and Human Services Chronic Disease Prevention and Control Program seeks to promote the community’s voice within the health care system through the development of the Community Health Worker role (including Promotores de Salud, Community Health Representatives, Community Health Advisors, and related titles) and provides a forum to share resources and strategies. For more information on the Chronic Disease Prevention and Control Program, please click here.
CHW Core Competencies
The Nebraska CHW Coalition Steering committee approved the following CHW Core Competencies on April 29, 2014.
A. Communication Skills
- Ability to use Active Listening
- Ability to communicate in writing
- Ability to communicate verbally
CHWs will communicate with varied populations, individuals, other community health workers, and professionals in a manner that is appropriate for the audience.
Effective cross cultural communication is a central aspect of CHW activity in all areas. They must be able to use relevant languages, be respectful, and demonstrate knowledge of the cultural group(s) they are engaging. They must be able to convey their knowledge base of basic health and social concerns that are meaningful to the clients and families, especially when behavior patterns are deeply rooted in traditions. Sensitivity must be used when attempting to discuss options and reasons for change.
CHWs are required to write and prepare clear reports on their clients, activities, and assessments of individual and community needs. They will be expected to give presentations regarding the needs and concerns of their clients and communities. Competence in writing and technical skills is expected to increase with experience. CHWs are encouraged to be able to read and write in English, but it may not be essential depending upon their area of focus.
B. Interpersonal skills
- Ability to build relationships
- Ability to work as part of a team
- Ability to understand and work within cultural dynamics
CHWs work with a diverse group of individuals including community members and professionals. They must be able to develop and maintain relationships at all levels. They must be able to work as part of a team, and consider, understand, and respect various perspectives to meet the needs of others.
C. Capacity Building
- Understanding of and ability to apply leadership
- Ability to develop additional skills
- Ability to develop and manage resources
- Ability to use planning skills
- Ability to produce complete, accurate reports
- Understanding of needs assessments
CHWs will increase the capability of their community to be empowered to care for themselves. They will also work collectively with community members and stakeholders to develop plans to increase resources in the community and to expand public awareness of community needs.
D. Teaching Skills
- Ability to teach one-on-one and/or in group settings
- Ability and willingness to learn and be proficient with information being presented
- Ability to lead classes or educational sessions
- Recognize need to continue education
- Ability to adapt teaching style to audience needs
CHWs teach and provide health and social service information and education to individuals they assist. They will effectively support and engage clients and their families in making behavioral changes, following treatment suggestions, and identifying barriers to change that are mutually acceptable and understood by the client, families, and community contact. They will have the ability to make appropriate referrals when needed.
E. Advocacy Skills
- Ability to be assertive and respectful
- Ability to listen and ask questions
- Ability to advocate at different professional levels
- Ability to identify and manage risky situations
- Ability to strengthen social support networks
CHWs must be able to advocate effectively with others so that the individuals they serve are able to receive the services they need. They provide information and support to others and teach them how to advocate for their own needs. They must have knowledge and tools for conflict resolution.
F. Organizational Skills
- Ability to develop plans and set goals
- Ability to manage time and determine priorities
- Ability to manage a budget
- Ability to report and evaluate in community settings
CHWs must have good organizational skills to help support the individuals and families they serve. They must be able to help and teach others to set and achieve goals. They help individuals and families set appointments, follow up with care plans and help address barriers, and complete reporting requirements.
G. Service Coordination
- Ability to identify and access resources
- Ability to make appropriate referrals when needed
- Ability to network, form partnerships, and work with others in planning efforts
CHWs help coordinate the care of their clients. They will be familiar with the agencies and professionals in the community they serve in order to assist clients and families to secure needed care. They understand the need for, and boundaries of, medical interpretation and ability to be a patient advocate. They are able to network, participate in community and agency planning and evaluation efforts directed at improving care, and bring needed services into the community.
H. Outreach Methods and Strategies
- Ability to engage others
- Ability to foster collaborative relationships
- Ability to build trust within the community
CHWs must be committed to outreach efforts that are directed at “meeting the people where they are.” Outreach means furnishing health-related information and services to a population that has not been served or is underserved. CHWs use outreach strategies and methods in order to provide these services to populations or groups where they live, work, play, and congregate (such as churches, parks, grocery stores, community centers, etc.). They assist the community in finding, using, creating, and supporting resources among community members and systems of care.
I. Client and Community Assessment
- Ability to understand basic surveys, interviews, and observational methods
- Ability to understand living process of communities
- Ability to understand population health data
CHWs must continue to identify community and individual needs, concerns, and assets. They will use standard knowledge of basic health and social indexes to clearly define the needs of the community they are serving. CHWs will engage clients and their families in ongoing assessment of their needs and develop plans and strategies for clients, a targeted population, or community.
Nebraska Community Health Worker and Care Opportunities
CHWs bring rich and robust life experiences to their work that cannot be taught in a classroom. CHWs are able to serve their community and clients best by relating their own experiences to those of their clients. Currently, the CHW profession is a non-credentialed, non-licenses profession in the state of Nebraska. However, there are CHW education and training opportunities available for CHWs to help reinforce CHW’s diverse strengths in providing informal counseling, sharing appropriate health information, and building community capacity to address underlying causes of health inequities.
Nebraska Department of Health and Human Services (DHHS)
Community Health Workers and Chronic Training Program
This FREE online training is intended for CHWs and other individuals who assist clients in the prevention, management and self-management of chronic conditions such as high blood pressure, prehypertension, hypertension, prediabetes and asthma. This program complements CHW core competency training by providing CHWs with added education, skill building and access to resources for the prevention, management and self-management of chronic conditions. Once all five modules have been successfully completed, CHWs will receive certificates of completion for each of the five modules. This program is FREE to all Nebraska CHWs through 2018 ($80 value). To get started, click here and follow the registration instructions below.
Community Health Worker Chronic Disease Online Training Program Registration guide click here
Nebraska Health Navigation: Expand Access by Bridging Care
This is an online course offered through the Nebraska Department of Health and Human Services Women’s and Men’s Health Programs. This online course is provided FREE of charge. The course is highly interactive, involving online case studies, resources and participant discussion. Weekly sessions devised to fit within your own schedule. Expect to spend 2-3 hours per week during the course of the online workshop, including any assignments. There is a required, 1-day face-to-face training, prior to starting the online course. The course will then take approximately 10 weeks. There is a required 2-day, face-to-face skill building workshop. The course will conclude as the participant gains practical experience through a Community Health Worker Capstone Project. A certificate of course completion will be awarded upon completion.
Additional Information and Resources
Chronic Disease Prevention and Control Community Health Worker Toolkit
The Chronic Disease Prevention and Control Community Health Worker Toolkit contains information and activities on chronic diseases such as high blood pressure, prediabetes, and diabetes, in addition to information on nutrition, physical activity, and self-management. This information is presented in a format suited for CHWs and their engagement with clients. The CHW Chronic disease toolkit also includes handouts for CHWs to share with their clients and communities. The Nebraska Chronic Disease Prevention and Control CHW toolkit is unique because it covers, in plain language, lifestyle-related issues and risk factors for high blood pressure, diabetes, obesity as well as self-management of these chronic conditions.
Click here to download a complete copy of the Chronic Disease CHW Toolkit.
Developed by Stanford University, Living Well is a Chronic Disease Self-Management program and the Living Well with Diabetes program that is evidence-based. The program is a 6-session interactive workshop that helps people who have on-going health conditions learn real-life skills for living a full, healthy life. Participants learn how to take small steps towards positive changes and healthier living. The workshop will build participant confidence and improve their ability to manage day-to-day life. Click here to find out more about the Living Well Programs Nebraska.
National Diabetes Prevention Program
The National Diabetes Prevention Program—or National DPP—is a partnership of public and private organizations working to reduce the growing problem of prediabetes and type 2 diabetes. The partners work to make it easier for people with prediabetes to participate in evidence-based, affordable, and high-quality lifestyle change programs to reduce their risk of type 2 diabetes and improve their overall health. Click here to find out more about the National DPP in Nebraska.
Nebraska Community Health Worker Association
The Public Health Association’s Community Health Worker Association Section was created in January 2014 with the objective of giving Community Health Workers in Nebraska recognition for their work, giving them a voice that advocates for public health as well as their profession, providing avenues for further training and uniting all Community Health Workers across the state, and the entire nation.
Public Health Association of Nebraska
This group is active in identifying and resolving Nebraska’s health problems. It provides a forum for discussion and advocacy of the significant public health concerns facing Nebraska.
Nebraska Department of Health and Human Services
The Department of Health and Human Services (DHHS) provides important and oftentimes life-sustaining services to Nebraskans. Their of mission, “Helping people live better lives,” provides the motivation to effectively provide these services and make a difference in the lives of hundreds of thousands of people. As one of Nebraska’s largest state agency. DHHS’s values guide employees in achieving their mission of “Helping people live better lives” and effectively implementing state and federally-mandated programs and services that assist Nebraskans. These values include: constant commitment to excellence, high personal standard of integrity, positive and constructive attitude and actions, openness to new learning, and dedication to the success of others.
Nebraska Local Public Health Departments
When the Nebraska Health Care Funding Act was passed in May 2001, 16 new multi-county health departments were created. As a result, all Nebraska counties are now covered by a local health department. The Office of Community Health & Performance Management provides technical assistance to all local public health departments and monitors the funds that are distributed under the Act.
Click here to access a list and map of Nebraska’s Local Health Departments along with county and district health department websites.
Nebraska Association of Local Health Directors
This association is local public health departments’ center of excellence in leadership, best practices, research, partnership, support, and training.
Nebraska Hospital Association
The Nebraska Hospital Association represents Nebraska’s hospitals and health systems. It provides the hospitals with state and federal legislative advocacy, health care trend and regulatory information, educational programming, communication, and data reports.
Nebraska Rural Health Association
This association works for stronger rural and regional representation in setting rural health policy.
Center for Disease Control and Prevention (CDC): A Community Health Worker Training Resource
Provided by the CDC, A Community Health Worker Training Resource for Preventing Heart Disease and Stroke (2015) is an evidence-based, plain-language training resource and reference for CHWs as well as a curriculum that health educators, nurses, and other instructors can use to train CHWs. The updated resource has 15 chapters that show how CHWs can help individuals prevent or manage heart disease, stroke, high blood pressure and cholesterol, diabetes, depression and stress, and other lifestyle risk factors. Also included are sections about working with children and teens and helping individuals talk to their doctor and take medicines properly.
Link to CHW Training Resource for Preventing Heart Disease and Stroke – http://www.cdc.gov/dhdsp/programs/spha/chw_training/
National Diabetes Education Programs
The National Diabetes Education Program (NDEP) works with partners to reduce the burden of diabetes and prediabetes by facilitating the adoption of proven approaches to prevent or delay the onset of type 2 diabetes and the complications of diabetes. NDEP is a joint program of the Centers for Disease Control and Prevention and the National Institutes of Health. Click here to find out more about NDEP.
Rural Assistance Center Community Health Worker Toolkit
A product of the U.S. Department of Health and Human Services’ Rural Initiative, the Rural Assistance Center (RAC) was established in December 2002 as a rural health and human services “information portal.” RAC helps rural communities and other rural stakeholders access the full range of available programs, funding, and research that can enable them to provide quality health and human services to rural residents. The Rural Assistance Center CHW toolkit includes 8 free online modules describing program models, training approaches, program implementation & sustainability, evaluation, and connections to successful models.
HRSA Community Health Worker Models Toolbox:
This HRSA CHW Model Toolbox includes descriptions of multiple CHW roles, from the strictly lay provider based in the community to the healthcare delivery team member based within a healthcare provider organization. Resource descriptions and references are included for training programs, CHW implementation models, sustainability options, and CHW program evaluations. The HRSA Rural CHW Clearinghouse in Module 8 includes descriptions of successful rural CHW programs including contacts, program overviews, and CHW models implemented.
Community Health Worker Core Consensus (C3) Project
This project focuses on helping advance consensus in the U.S. Community Health Worker (CHW) field by producing recommendations for consideration and adoption on common elements of CHW Scope of Practice and Core Competencies. It is anticipated these recommendations, building on foundational work in the field, will be useful in various settings including in the design of training curricula and CHW practice guidelines for use at the local, state, and national levels.
Living Well with Chronic Conditions (CDSMP)
Developed by Stanford University, the Living Well with Chronic Conditions program is an effective self-management education program for people with chronic health problems. The workshops empower participants to take an active role in managing their health by giving them key skills needed to manage any chronic health condition. The program does not address disease specific topics. The program is a 6-session interactive workshop that helps people who have on-going health conditions learn real-life skills for living a full, healthy life. Participants learn how to take small steps towards positive changes and healthier living. The workshop will build participant confidence and improve their ability to manage day-to-day life. Family members and others who support people with a chronic condition are also encouraged to attend. Click here to find out more about the Living Well with Chronic conditions program.
Living Well with Diabetes (DSMP)
Developed by Stanford University, the Living Well with Diabetes program curriculum is more specific to diabetes self-management and covers topics such as monitoring blood sugar, healthy eating, list of recommended testing and preventative services, how to deal with sick days, foot care, and complications. The program is a 6-session interactive workshop that helps people who have on-going health conditions learn real-life skills for living a full, healthy life. Participants learn how to take small steps towards positive changes and healthier living. The workshop will build participant confidence and improve their ability to manage day-to-day life. Click here to find out more about the Living Well with Diabetes program.
The National Diabetes Prevention Program (National DPP)
The CDC – led National Diabetes Prevention Program (National DPP) is an evidence-based lifestyle change program for preventing type 2 diabetes. The yearlong program helps participants make real lifestyle changes such as eating healthier, including physical activity into their daily lives, and improving problem-solving and coping skills. Participants meet with a trained lifestyle coach and a small group of people who are making lifestyle changes. Click here to find out more about the National DPP.
Diabetes Self-Management Education/Training (DSME/T)
Diabetes Self-Management Education is a collaborative process that helps people with diabetes learn how to successfully manage this disease. The goal of diabetes education is to help people with diabetes practice self-care behaviors every day and be as healthy as possible. Click here to find out more about Diabetes Self-Management Education/Training.
The Department of Health and Human Services (DHHS) provides important and oftentimes life-sustaining services to Nebraskans. Their mission of, “Helping people live better lives,” provides the motivation to effectively provide these services and make a difference in the lives of hundreds of thousands of people. As one of Nebraska’s largest state agency, DHHS’s values guide their employees in achieving their mission and to effectively implement state and federally-mandated programs and services that assist Nebraskans. These values include: constant commitment to excellence, high personal standard of integrity, positive and constructive attitude and actions, openness to new learning, and dedication to the success of others.
When the Nebraska Health Care Funding Act was passed in May 2001, 16 new multi-county health departments were created. As a result, all Nebraska counties are now covered by a local health department. Click here to access a list and map of Nebraska’s Local Health Departments along with county and district health department websites.
The Nebraska Rural Health Association (NeRHA) is a non-profit, grassroots, member-driven organization that is interested in the health of rural Nebraskans throughout the state. The NeRHA membership works together to identify health concerns of rural Nebraska and to find ways to improve services in our communities. Click here to find out more about NeRHA.
The following materials were created to inspire communities to take a proactive approach in improving health across the board. This toolkit makes accessing valuable information about lifestyle choices like eating and physical activity easier, Download, print, and share to make the most of the resources available. From health care professionals to consumers, these pieces research, helpful tips and support needed to take the first steps toward a healthier living regardless of whether or not you are currently living with or at risk of a chronic disease.