Pullen-Smith Barbara, Carter-Edwards Lori, Leathers Kimberly H
NC Office of Minority Health and Health Disparities, NC Department of Health and Human Services, Raleigh, NC 27609, USA.
J Public Health Manag Pract. 2008 Nov;14 Suppl:S73-81. doi: 10.1097/01.PHH.0000338391.90059.16.
Despite public health efforts to address burden of diseases within communities such as diabetes, health disparities remain. Traditional lay health advisor models help address these issues. Yet, few, if any, have a statewide focus that includes education credit and involves broad-based partnerships. The Community Health Ambassadors Program (CHAP) is a training and education demonstration program designed to engage leaders from diverse communities to help eliminate health disparities in North Carolina. The program's current focus is on improving diabetes awareness, management, and prevention. CHAP involves multiple state and local community and healthcare professional partnerships, the community college system, and tribal, community-, and faith-based organizations. CHAP components include recruitment, training (classroom and interactive instruction, fieldwork, and continuing education credits), monitoring/evaluation, and support/education. Since CHAP's inception in June 2006, 146 community health ambassadors (CHAs) from 17 counties have been trained. Preliminary evaluation of the CHA community activities include one-on-one diabetes self-management tips, diabetes talks, and recruitment of citizens to sign healthy living pledges. CHAP may be a comprehensive and cost-effective model for promoting multilevel involvement of community leaders and diverse organizations to concentrate on diabetes health disparities within the state. CHAP will be implemented in the future to address the state's other prevailing health problems.
尽管公共卫生部门努力应对社区内的疾病负担，如糖尿病，但健康差距依然存在。传统的非专业健康顾问模式有助于解决这些问题。然而，很少有模式（如果有的话）以全州为重点，包括教育学分，并涉及广泛的伙伴关系。社区健康大使计划（CHAP）是一个培训和教育示范项目，旨在让来自不同社区的领导人参与进来，帮助消除北卡罗来纳州的健康差距。该计划目前的重点是提高糖尿病意识、管理和预防。CHAP涉及多个州和地方社区以及医疗保健专业伙伴关系、社区学院系统以及部落、社区和基于信仰的组织。CHAP的组成部分包括招募、培训（课堂和互动教学、实地工作以及继续教育学分）、监测/评估以及支持/教育。自2006年6月CHAP启动以来，已培训了来自17个县的146名社区健康大使（CHA）。对CHA社区活动的初步评估包括一对一的糖尿病自我管理提示、糖尿病讲座以及招募公民签署健康生活承诺书。CHAP可能是一个全面且具有成本效益的模式，可促进社区领导人及多元化组织的多层次参与，以关注该州内的糖尿病健康差距。未来将实施CHAP以解决该州其他普遍存在的健康问题。
