Addressing Health Disparities from Within the Community: Community-Based Participatory Research and Community Health Worker Policy Initiatives Using a Gender-Based Approach.

BACKGROUND

The Coalition for a Healthier Community for Utah Women and Girls (CHC-UWAG) focused on addressing obesity-related health disparities impacting Utah women of color using community-based participatory research, a gender-based approach, and culturally sensitive health promotion activities delivered through community health workers (CHWs). A randomized trial of low vs. high intensity wellness coaching by CHWs was initiated. During this process, numerous policy issues emerged and were tracked. We present a case study illustrating how we identified, tracked, and engaged with emerging policy initiatives.

METHODS

Between September 2011 and August 2017, policy initiatives addressing obesity-related disparities among Utah women and girls were identified, tracked in a shared document, and updated regularly. Policies were classified by level (organizational, local, and statewide) and by focus (healthy eating, active living, and promotion of community health workers). CHC-UWAG engagement with policy work was also documented and tracked.

RESULTS

Broad dissemination of study findings generated interest in the role of CHWs in addressing obesity. Partnering community-based organizations implemented policies focused on healthy eating and physical activity. Barriers to the broader use of CHWs in Utah were addressed in policy initiatives including the formation of a Utah Public Health Association Section for CHWs and a statewide CHW Coalition with involvement of CHC-UWAG members.

CONCLUSIONS

The regular solicitation of information about policy initiatives resulted in successful policy tracking and engagement in policy work. The utilization of a gender-based approach helped illuminate the impact of emerging policies on the health of women and girls.