Sinai Urban Health Institute, Sinai Chicago, Chicago, Illinois, USA.
Popul Health Manag. 2022 Apr;25(2):280-283. doi: 10.1089/pop.2021.0376.
The COVID-19 response has resulted in broader awareness of health inequities across the United States and their impact on overburdened and under-resourced communities. Investing in and more effectively integrating community health workers (CHWs) into health care delivery been prioritized in the COVID-19 response given the importance of trust and community connection to move people toward behavior change during times of uncertainty. CHWs serve as liaisons and connectors between patients, communities, and health/social care systems, providing culturally appropriate education and addressing complex social needs within the individual and community context. Given the pervasive health inequities that continue to persist despite decades of efforts to curb them, health care systems should reimagine current care delivery models to fully integrate CHWs into care teams. However, barriers exist to effectively deploying CHWs in health care systems. Through 20 years of experience developing, implementing, evaluating, and scaling CHW interventions, Sinai Urban Health Institute has learned valuable lessons in overcoming the common barriers to true and effective CHW integration. Organizations that approach CHW program implementation with a deliberate focus on recruitment and training and career pipelines/pathways, and adequately prepare their organization for CHWs will realize the benefits this unique workforce has to offer. Our experiences have demonstrated that if you hire the right people, train them effectively, and provide appropriate supervision, CHWs are transformative to health care delivery. We discuss our solutions in these areas within the context of integrating CHWs into our health care system to work with our most medically and socially complex patients.
在 COVID-19 应对过程中，人们更加意识到美国各地存在健康不平等现象，以及这些不平等现象对负担过重和资源不足的社区的影响。鉴于信任和社区联系对于在不确定时期促使人们改变行为的重要性，在 COVID-19 应对过程中，将社区卫生工作者（CHW）纳入医疗保健服务的投资和更有效地整合已被提上优先事项。CHW 是患者、社区和卫生/社会保健系统之间的联络人和联系人，他们在个人和社区背景下提供文化上适宜的教育，并解决复杂的社会需求。尽管数十年来一直努力遏制这些健康不平等现象，但它们仍然普遍存在，因此医疗保健系统应该重新构想当前的护理提供模式，将 CHW 全面纳入护理团队。然而，在医疗保健系统中有效部署 CHW 仍然存在障碍。通过 20 年的开发、实施、评估和扩大 CHW 干预措施的经验，西奈都市健康研究所吸取了宝贵的经验教训，克服了 CHW 真正有效整合的常见障碍。那些在招聘和培训以及职业渠道/途径方面有明确重点、充分为 CHW 做好组织准备的组织，将认识到这支独特的劳动力所能带来的好处。我们的经验表明，如果您招聘合适的人员，对他们进行有效培训，并提供适当的监督，CHW 将对医疗保健服务产生变革性影响。我们将在将 CHW 纳入我们的医疗保健系统以与我们最需要医疗和社会服务的患者合作的背景下讨论我们在这些领域的解决方案。
