Community health workers (CHWs) are increasingly recognized as crucial personnel for local health departments (LHDs) and public health initiatives. As highlighted by recent findings in the NACCHO 2023 Forces of Change survey, engaging CHWs has proven essential for enhancing LHDs’ capacity to effectively conduct public health activities. CHWs are instrumental in connecting residents to resources, providing health education, and addressing social determinants of health. However, challenges such as competitive wages and limited knowledge about CHW roles remain significant barriers. In this blog post, we spotlight two exemplary Prevention Research Centers that have successfully integrated CHWs into their interventions. As LHDs continue to harness the potential of CHWs, these models offer scalable solutions for enhancing public health across diverse communities.

The Prevention Research Center at the University of Arizona: Pioneering Health Equity in Latine Communities

For over two decades, the Prevention Research Center at the University of Arizona (AzPRC) has been at the forefront of addressing chronic disease disparities in Latine communities along the US-Mexico border in Arizona. This impressive history of collaboration with local health agencies, organizations, and community partners is not just about research; it’s about fostering meaningful change and promoting health equity in these diverse communities. The AzPRC uses a community-based participatory research (CBPR) approach that strives to build mutual capacity among all partners and ensures that the community’s voice is central to their efforts.

Central to AzPRC’s efforts is the Community Action Board, a vibrant collective comprising twenty organizations and programs. This board is a driving force behind developing and implementing evidence-based strategies. A critical aspect of these strategies is the training and collaboration with community health workers, who play an essential role in health promotion and disease prevention. Their work extends to implementing environmental and system change strategies along the border, addressing health disparities with a nuanced understanding of the local context. One of the key achievements of AzPRC has been the establishment of trust within the community members of the border and tribal areas. This trust is the bedrock upon which all successful health interventions are built. Through partnerships, AzPRC has not only engaged communities but also empowered them, fostering resilience and self-sufficiency.

AzPRC’s core project, Unidos: Linking Individuals to Social Determinant and Community Health Services, exemplifies their commitment to innovative, community-centric interventions. Unidos is designed to reduce chronic disease risk while promoting social and cultural resilience in the Latine community. This intervention is a collaborative effort, partnering with several county health departments across Arizona, including Yuma County Health District, Pima County Health Department, and Maricopa County Health Department.

Unidos leverages the Sociocultural Resilience Model (SRM), focusing on two pivotal concepts: cultural processes and social networks. These concepts are adapted to reflect the unique needs and strengths of the communities served:

• Social Networks: Within the context of Unidos, social networks encompass the support systems integral to the Latine community. This includes family, friends, coworkers, and extends to both formal and informal settings like walking groups. These networks provide essential platforms for learning communication skills that bridge intergenerational, cultural, and language gaps.
  
• Cultural Processes: Cultural processes involve the beliefs, behaviors, traditions, religion, food, and language that define a group. In Unidos, these processes are honored and leveraged through activities such as intergenerational storytelling, shared meals, and cultural expressions like dance, fostering a rich exchange of traditions and support.

The AzPRC continues to develop tools and resources that empower communities and health professionals alike. To delve deeper into their work and access valuable tools and resources, visit the provided links below:

• Arizona Prevention Research Center
• Capacity Building & Training Tools
• Replication Guide | UArizona Prevention Research Center
• CBPR guides for vetting research projects

Contact Information

Maia Ingram, MPH
AzPRC Director of Community Engagement and Translation
[email protected]

NYU-CUNY Prevention Research Center: Driving Innovation in Chronic Disease Prevention and Transforming Community Health

The New York University & City University of New York Prevention Research Center (NYU-CUNY PRC) has been spearheading community- and clinic-based interventions for chronic disease prevention and management. Now in their third consecutive funding cycle, NYU-CUNY PRC continues to drive initiatives that create a tangible difference across various settings, diverse populations, and disease conditions. A key strategy in their approach is the integration of community health workers into their programs.

Through strategic partnerships with NYU Langone and the CUNY Graduate School of Public Health and Health Policy, NYU-CUNY PRC has successfully completed several CDC-funded projects:

Reaching Immigrants through Community Empowerment (Project RICE)

This initiative focused on diabetes prevention among Korean American and South Asian American immigrants through a community health worker-led educational intervention. Project RICE demonstrated significant improvements in diabetes knowledge, weight management, and mental health among participants. The findings from this initiative have been influential in promoting the use of CHWs in diabetes prevention and adapted curriculum have been promoted by the National Diabetes Prevention Program.

Implementing Million Hearts® for Provider and Community Transformation (Project IMPACT)

This project enhanced cardiovascular health among South Asians in New York City by integrating electronic health records with culturally tailored community health worker interventions. Successes included improved blood pressure control and overall cardiovascular health, setting a precedent for integrating technology and community-driven approaches in chronic disease management. Components of this model are currently being scaled throughout NYU’s health system.

The results from both projects underscore the importance of employing CHWs to engage with populations disproportionately affected by health disparities. Building on their previous successes, NYU-CUNY PRC is partnering with the local health department to lead the evaluation of two programs, including understanding the impact of the program in improving health and examining the barriers and facilitators to program implementation to inform sustainability and scale:

Harlem Health Advocacy Partnerships (HHAP)

HHAP is an LHD-led initiative that connects residents of the New York City Housing Authority in East and Central Harlem with CHWs to better manage diabetes, hypertension, and asthma.

NYC Health Justice Network (NYC HJN)

NYC HJN is an LHD-led initiative that aims to improve access to primary care and social services for individuals with a history of justice involvement through a robust network of CHWs.

Ongoing Efforts

The NYU-CUNY PRC continues to expand its research and programs to address the health and needs of vulnerable populations. By fostering multi-sector collaborations, blending research with practical interventions, the NYU-CUNY PRC is not only enhancing public health but also creating scalable CHW models that other communities can adapt and replicate, underscoring their commitment to a healthier future for underserved populations.

For more detailed insights into their groundbreaking work, you can explore their resources and publications at the links below:

• Launching a Neighborhood-Based Community Health Worker Initiative
• NYU CUNY PRC Community Health Worker Toolkit
• New York City Health Justice Network and the Harlem Health Advocacy Partners program
• Project IMPACT and Project RICE

Contact Information

Nadia Islam, PhD
Professor of Population Health
[email protected]