The Bridge to Saving Lives: Community Health Workers

Carolina Lopez de la Torre, MPH, Institute for Behavioral and Community Health Studies

Elva M. Arredondo, Ph.D., Institute for Behavioral and Community Health Studies and School of Public Health at San Diego State University

Chronic diseases are conditions that persist over a long period, such as cancer, cardiovascular disease, and diabetes. While these chronic diseases are one of the leading causes of death in the United States, they are also the most preventable. Many these diseases can be prevented by:

• Receiving preventive services (e.g., cancer screening and vaccinations)
• Eating a healthy diet
• Being physically active
• Not smoking

Integrating community health worker programs into the workforce has been a culturally appropriate and effective approach to promote disease prevention within communities.
 

What are Community Health Workers?

Community health workers are frontline public health workers who are trusted members of the community they serve. Community health workers may hold different titles such as Promotores de Salud, Lay Health Advocate, Outreach Educator, and Peer Health Promoter.
 

Community Health Workers and Preventative Care

As members of the community, community health workers have a deep understanding of the community’s culture, language, and priorities. Public health programs need to be culturally appropriate to provide information and resources in a way that is consistent with the community’s beliefs, values, and traditions. Group-based education by community health workers offers a sensitive cultural approach that reaches community members at higher risk for chronic diseases.

Many people within these communities are afraid of the word “cancer” and may associate it with death. This association can paralyze people from acting. Some may also be unaware of preventative services available to them. They may also be unsure of how to navigate the healthcare system. 

Community health workers offer a personal and culturally appropriate approach to health education within their communities. There is evidence that this approach can be effective in increasing screening for certain types of cancer.
 

The JUNTOS Program

The Juntos Contra el Cáncer/United Against Cancer (JUNTOS) program was a community health worker-led cancer prevention study. It provided colorectal cancer prevention workshops to adults ages 50 to 75 in a primarily Latino community in San Diego, CA.

Community health workers educated participants about colorectal cancer, risk factors, and screening methods. They then followed up via telephone and assisted in scheduling appointments with a partnered Federally Qualified Health Center (FQHC).

Two Community Health Workers were hired through the partnered FQHC. They received over 80 hours of training to:

• Recruit and screen potential participants
• Lead colorectal cancer screening workshops
• Administer informed consent and surveys
• Schedule participants for clinical visits at the partnered Community Health Clinic

Cancer screening can help prevent colorectal cancer through the detection and removal of precancerous growths. Screening can also help detect early stages of colorectal cancer when treatment is more likely to be successful.
 

A Personal Connection

Mirna Díaz was a community health worker for over fifteen years before joining the JUNTOS Program. She credits JUNTOS for saving her mother’s life.

Ms. Díaz taught her mother, who was visiting from Guatemala, the training she received on colorectal cancer prevention and early detection. Her mother was 78 years old at that time. 

Ms. Diaz’s mother had never been screened for colorectal cancer. She did not know what colorectal cancer was or the importance of screenings after age 50.

Ms. Diaz’s mother returned to Guatemala and asked her primary care provider for the screening. The screening came in positive, and further evaluation confirmed it was colorectal cancer. Fortunately, the cancer was detected early, and treatment was successful.
 

JUNTOS Program Results

Early results indicate that six months after participating in JUNTOS, about 60% of participants who were previously behind on colorectal cancer screenings were now up-to-date. Participants served by the JUNTOS Program have expressed their gratitude to the community health workers for the quality of information they provided as well as the humane treatment they received.

Both community health workers involved in the program, Mirna and Gabriel López, agree that they bring respect and love that community members appreciate. Their personal connection with the community members due to similar culture and life experiences is essential.

Their respect and love creates trust among community members and a platform for receptive interaction. Even if a community member mistrusts the health care system, they trust Mirna and Gabriel. This often leads them to contact the clinic to start a conversation with a physician about colorectal cancer screening. This has helped improve patients’ trust with all health care providers in the future. 

 

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