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Strengthening the role of Community Health Representatives in the Navajo Nation

BACKGROUND: Strengthening Community Health Worker systems has been recognized to improve access to chronic disease prevention and management efforts in low-resource communities. The Community Outreach and Patient Empowerment (COPE) Program is a Native non-profit organization with formal partnerships...

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Autores principales: King, Caroline, Goldman, Alex, Gampa, Vikas, Smith, Casey, Muskett, Olivia, Brown, Christian, Malone, Jamy, Sehn, Hannah, Curley, Cameron, Begay, Mae-Gilene, Nelson, Adrianne Katrina, Shin, Sonya Sunhi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5399395/
https://www.ncbi.nlm.nih.gov/pubmed/28431541
http://dx.doi.org/10.1186/s12889-017-4263-2
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author King, Caroline
Goldman, Alex
Gampa, Vikas
Smith, Casey
Muskett, Olivia
Brown, Christian
Malone, Jamy
Sehn, Hannah
Curley, Cameron
Begay, Mae-Gilene
Nelson, Adrianne Katrina
Shin, Sonya Sunhi
author_facet King, Caroline
Goldman, Alex
Gampa, Vikas
Smith, Casey
Muskett, Olivia
Brown, Christian
Malone, Jamy
Sehn, Hannah
Curley, Cameron
Begay, Mae-Gilene
Nelson, Adrianne Katrina
Shin, Sonya Sunhi
author_sort King, Caroline
collection PubMed
description BACKGROUND: Strengthening Community Health Worker systems has been recognized to improve access to chronic disease prevention and management efforts in low-resource communities. The Community Outreach and Patient Empowerment (COPE) Program is a Native non-profit organization with formal partnerships with both the Navajo Nation Community Health Representative (CHR) Program and the clinical facilities serving the Navajo Nation. COPE works to better integrate CHRs into the local health care system through training, strengthening care coordination, and a standardized culturally appropriate suite of health promotion materials for CHRs to deliver to high-risk individuals in their homes. METHODS: The objective of this mixed methods, cross sectional evaluation of a longitudinal cohort study was to explore how the COPE Program has effected CHR teams over the past 6 years. COPE staff surveyed CHRs in concurrent years (2014 and 2015) about their perceptions of and experience working with COPE, including potential effects COPE may have had on communication among patients, CHRs, and hospital-based providers. COPE staff also conducted focus groups with all eight Navajo Nation CHR teams. RESULTS: CHRs and other stakeholders who viewed our results agree that COPE has improved clinic-community linkages, primarily through strengthened collaborations between Public Health Nurses and CHRs, and access to the Electronic Health Records. CHRs perceived that COPE’s programmatic support has strengthened their validity and reputation with providers and clients, and has enhanced their ability to positively effect health outcomes among their clients. CHRs report an improved ability to deliver health coaching to their clients. Survey results show that 80.2% of CHRs feel strongly positive that COPE trainings are useful, while 44.6% of CHRs felt that communication and teamwork had improved because of COPE. CONCLUSIONS: These findings suggest that CHRs have experienced positive benefits from COPE through training. COPE may provide a useful programmatic model on how best to support other Community Health Workers through strengthening clinic-community linkages, standardizing competencies and training support, and structuring home-based interventions for high-risk individuals.
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spelling pubmed-53993952017-04-24 Strengthening the role of Community Health Representatives in the Navajo Nation King, Caroline Goldman, Alex Gampa, Vikas Smith, Casey Muskett, Olivia Brown, Christian Malone, Jamy Sehn, Hannah Curley, Cameron Begay, Mae-Gilene Nelson, Adrianne Katrina Shin, Sonya Sunhi BMC Public Health Research Article BACKGROUND: Strengthening Community Health Worker systems has been recognized to improve access to chronic disease prevention and management efforts in low-resource communities. The Community Outreach and Patient Empowerment (COPE) Program is a Native non-profit organization with formal partnerships with both the Navajo Nation Community Health Representative (CHR) Program and the clinical facilities serving the Navajo Nation. COPE works to better integrate CHRs into the local health care system through training, strengthening care coordination, and a standardized culturally appropriate suite of health promotion materials for CHRs to deliver to high-risk individuals in their homes. METHODS: The objective of this mixed methods, cross sectional evaluation of a longitudinal cohort study was to explore how the COPE Program has effected CHR teams over the past 6 years. COPE staff surveyed CHRs in concurrent years (2014 and 2015) about their perceptions of and experience working with COPE, including potential effects COPE may have had on communication among patients, CHRs, and hospital-based providers. COPE staff also conducted focus groups with all eight Navajo Nation CHR teams. RESULTS: CHRs and other stakeholders who viewed our results agree that COPE has improved clinic-community linkages, primarily through strengthened collaborations between Public Health Nurses and CHRs, and access to the Electronic Health Records. CHRs perceived that COPE’s programmatic support has strengthened their validity and reputation with providers and clients, and has enhanced their ability to positively effect health outcomes among their clients. CHRs report an improved ability to deliver health coaching to their clients. Survey results show that 80.2% of CHRs feel strongly positive that COPE trainings are useful, while 44.6% of CHRs felt that communication and teamwork had improved because of COPE. CONCLUSIONS: These findings suggest that CHRs have experienced positive benefits from COPE through training. COPE may provide a useful programmatic model on how best to support other Community Health Workers through strengthening clinic-community linkages, standardizing competencies and training support, and structuring home-based interventions for high-risk individuals. BioMed Central 2017-04-21 /pmc/articles/PMC5399395/ /pubmed/28431541 http://dx.doi.org/10.1186/s12889-017-4263-2 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
King, Caroline
Goldman, Alex
Gampa, Vikas
Smith, Casey
Muskett, Olivia
Brown, Christian
Malone, Jamy
Sehn, Hannah
Curley, Cameron
Begay, Mae-Gilene
Nelson, Adrianne Katrina
Shin, Sonya Sunhi
Strengthening the role of Community Health Representatives in the Navajo Nation
title Strengthening the role of Community Health Representatives in the Navajo Nation
title_full Strengthening the role of Community Health Representatives in the Navajo Nation
title_fullStr Strengthening the role of Community Health Representatives in the Navajo Nation
title_full_unstemmed Strengthening the role of Community Health Representatives in the Navajo Nation
title_short Strengthening the role of Community Health Representatives in the Navajo Nation
title_sort strengthening the role of community health representatives in the navajo nation
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5399395/
https://www.ncbi.nlm.nih.gov/pubmed/28431541
http://dx.doi.org/10.1186/s12889-017-4263-2
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