community health workers: a scoping review of hics

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Community Health Workers: A scoping review of HICs. Maisam Najafizada, Ivy Bourgeault , Ronald Labont é , Sara Torres, Corinne Packer Institute of Population Health University of Ottawa . The marginalized vs the health system. The problem. - PowerPoint PPT Presentation


Community Health Workers: A scoping review of HICsMaisam Najafizada, Ivy Bourgeault, Ronald Labont , Sara Torres, Corinne Packer

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1The marginalized vs the health system

The problemHealth inequities among marginalized populations (Immigrants, aboriginals, and low-income and homeless populations)MeaningInappropriate utilization of health care servicesA lack of access to or underutilization of primary health care servicesAn overutilization of emergency departments, and professional servicesThe grassroots solutionIndividuals with good knowledge of communities (mostly one of their members) who has good knowledge of the health systemHealth NavigatorsPromotoras (Spanish Population)Community Health Representatives (Aboriginals)Peer Health EducatorHealth Trainers (UK)The questionWhat do we know about CHWs in Canada?What is there to know about CHWs in countries like Canada i.e. the United States, the UK, Europe, Australia?Comparing the two, where is the research gap in Canada?Arksey and OMalley Method of Scooping review: Identifying research questionIdentifying relevant studiesStudy selectionCharting dataCollating, summarizing and reporting the results

How is the study conducted?6Flowchart of articles included in the studyElectronic Database Search (n=409 articles)Gross number of articles in each sourceMedline (n= 121)Embase (n= 126)CINAHL 9 (n=142)Grey Literature (n=20)Abstract review (n=409)Articles excluded based on abstract review(n=294)Reason for exclusion: Did not have CHWs as the main focus Full screening (n=115)Articles excluded based on full screening(n=58)Reason for exclusion: Does not focus on health promotion, disease prevention, social determinants of healthData extraction (n=64)Who are they & what do they do?A frontline public health worker Trusted member of and/or has an unusually close understanding of the community served. Serves as a liaison/link/intermediary between health/social services and the community to facilitate access to services and improve the quality and cultural competence of service delivery. Builds individual and community capacity by increasing health knowledge and self-sufficiency through a range of activities such as outreach, community education, informal counselling, social support, and advocacy. Typology of CHWs in CanadaCommunity Health Representatives: Aboriginal populationCommunity Facilitator and Community Support Workers: CancerCare Manitoba:Women Health Educators (WHEs): HamiltonCommunity Health Brokers: Hamilton, Niagara, Brant, and Haldimand Norfolk Multicultural Health Brokers: Edmonton, Alberta; Sommerset West Community Center, Ottawa. Cross Cultural Health Brokers: British Columbia Peer Leader (lay health educator): TorontoRecruitmentTypes of recruitmentRecruited by community organizationsRecruited by public health system in small projectsRecruited by communities (Rarely)Criteria Community originKnowledge of the community

What will the audience be able to do after this training is complete? Briefly describe each objective and how the audience will benefit from this presentation.10Education & TrainingType of trainingOn-the-job trainingHealth organization trainingEducational institution trainingNo trainingContent of trainingHealth promotion and disease preventionAccess to health systemCommunity development-related trainingDisease-specific trainingAdministrative and research related Accreditation & RecognitionInternationallyCHW as a standard job classification in US in 2010Minnesota and Massachusetts have integrated CHWs in their health systemHealth Trainer in the national health services of the UKCanadaUnregulated and unrecognized in Canada

CHW as a careerSustainability of CHW programsIntegration of CHW programs into the health systemCompensationType of paymentPaid low wagesNot paid for the amount of time actually works Employed/paid at intervals when projects have fundingFactors in paymentTrainingAccreditation FundingDiscussionWhats knownCHWs are a reality under various titlesTakes a holistic approacha) Positive health impact b) reduce health disparity, c) potential to control/reduce high costs of medical/hospital servicesA component of patient-centered health systemsWhats not known in CanadaNo complete pictureNo evidence on Their cost-effectivenessInteraction with other sectorsEnablers and barriers to these rolesIdentification and recommendation for policy and program change

ConclusionCHWs are a grassroots reality in Canada, Who needs to be identified and researched nationally, Who needs to be recognized by the governments,Who needs to be regulated within the health care system Questions and comments


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