As health systems, community-based organizations and other changemakers work toward healthier, more equitable communities, many are exploring the impacts of integrating Traditional Health Workers (THWs) into their programs. THW is an umbrella term for a variety of roles: Community Health Workers, Doulas, and Peer Support Specialists, to name a few. While these titles reflect key differences in scope and focus, all THWs work as trusted members of their communities who walk alongside others facing barriers to good health to promote healthy behaviors, connect them to services, and help coordinate care.
At CORE, we’re engaged in a variety of research, evaluation, and cross-sector coalition building efforts that place THWs at the center of new care models and innovative programs. These projects illustrate some of the ways THWs are building trust, shaping policy, and improving care and outcomes.
Below we’ve summarized three key ways THWs can support your mission and clients. These are just a few examples from a growing body of work here at CORE. For more info, get in touch!
As organizations consider integrating THWs into their programs, the question for many decision-makers is whether this approach can measurably improve outcomes. Measuring THW impact can be tricky, as they often work within multifaceted programs. Plus, sample sizes in pilot or early stage programs are often small. However, despite these challenges, in many of the programs evaluated by CORE, we saw promising results.
For example, in Kaiser Permanente’s Housing for Health Initiative, which served roughly 400 clients with CHWs, we observed a 49 percent reduction in the likelihood of sleeping on the street, in a car, campsite or similar space, and a 57 percent increase in not going without food. In another project, where 240 pregnant individuals with substance use disorder (SUD) received support from peer mentors trained as doulas, participants had a 70 percent reduction in the odds of having a pre-term birth compared to non-participants.
These figures illustrate the potential for THWs to play a key role in helping drive better outcomes.
At a time when trust in healthcare is on the decline, THWs can play a powerful role in building trust between community members and those that serve them. Through hundreds of interviews and surveys across multiple programs, one consistent theme emerged: Having shared lived experiences with a THW makes people feel like they have someone on their side who “gets it” – because the THW has been there too.
THWs are trusted members of their communities, typically with similar backgrounds, experiences, language, and culture as those they serve. This helps them build authentic relationships and address clients’ experiences of stigma within health care and social service settings. It also allows THWs to break down barriers and connect community members to care and services, because they have navigated those very systems in their own lives.
Informing and Improving Policy
THWs are natural researchers who can elevate community needs and drive meaningful policy and system change. Their lived experience and experience interacting with the populations they serve empowers them to identify the barriers that individuals and populations face – from inequities to cost to access to quality care – and propose solutions. The implications for organizational and public policy are significant.
Take, for example, the Rose Village Community Health Worker team in Southwest Washington State. Through testimony, advocacy, and outreach, this neighborhood-based team influenced a number of impactful policies ranging from tenant protections to local public transportation service. And in other projects, we observed THWs advocating for internal policy changes and improvements to existing programs and interventions.
“To have people like (THWs) who care about social justice, health, and anti-poverty issues and are willing to go and talk to lawmakers… it’s huge” – Community Partner
These are just a few of the ways THWs can contribute to programs that advance whole-person care and shape better care experiences and outcomes for those facing significant barriers to health and equity.
Are you considering integrating THWs into your programs, or are you looking to evaluate the impact of your existing THW-centered programs? Contact us today to discuss how CORE can help.