Healthy Families Brooklyn: Working with Health Advocates to Develop a Health Promotion Program for Residents Living in New York City Housing Authority Developments

Abstract

Decreasing health disparities must increase access to care, improve health education and ease navigating the health care system. Community Health Workers (CHW) take on these tasks in professional and culturally competent manners. The Healthy Families Brooklyn (HFB) Program serves residents in two public housing developments in Brooklyn, NY. Healthy Families Advocates (HFA), a type of CHW, are at the core of HFB. Curriculum development for, training of and services provided by the 10 HFA over 19 months are described. Pre and post knowledge assessments of HFAs are analyzed. Data from HFA surveys regarding training were analyzed using grounded theory methods. HFA served 172 unique clients at 222 visits. Services offered include accessing public benefits, health education, and connection to hospitals. There was a significant increase between pre and post assessment knowledge scores (P < 0.01). Taking temperature, building trust, and communicating care and connection emerged as themes related to interpersonal skills used by the HFA. The HFA are committed to moving clients forward in their health knowledge and behaviors. Themes from the HFA survey closely mirrored the HFA training curriculum. Lessons learned pertaining to training needs, data collection, and supervision are explored. The HFB program is a model way of working in communities in New York City and expansion with faith-based groups and other housing development communities is underway. Engaging communities to improve access, screening, prevention and treatment is paramount to the nation's health and the success of the 2010 Affordable Care Act. CHW's role in this mission is integral.

Navigation delivery models and roles of navigators in primary care: a scoping literature review

“…Health Systems Issues were addressed by navigators in 13 papers. Navigators assist with fragmentation of health and social health care system through various methods, including communication [ 10 – 12 , 14 ], access to care [ 10 , 13 , 14 ], navigating the system and services [ 13 , 15 , 16 ], health insurance [ 12 , 33 , 36 ], inappropriate care delivery [ 33 , 37 , 38 ], clients without permanent providers [ 10 ], and the need for better transitions [ 39 ]. In eight papers, Disease Specific Issues were addressed.…”

“…Medically complex patients in primary care experience fragmentation and gaps in service delivery, primary care reforms involving system navigation may support the management of this patient population [ 7 – 9 ]. Navigators assist with fragmentation of the health and social health care system through various methods including: communication with multiple agencies [ 10 – 12 ], facilitating access to care [ 10 , 13 , 14 ], navigating the system and services [ 13 , 15 , 16 ], or assisting individuals with health insurance. Primary care lends itself well to the concept of system navigation, since one of its key features is the coordination of care across health care providers and services in the interest of person-centred care [ 17 , 18 ].…”

Partnering with insiders: A review of peer models across community-engaged research, education and social care

“…As noted in several of the reviewed articles, peers working within peer models can benefit directly from increased knowledge and practice of research skills, enhanced self‐esteem, confidence and feelings of empowerment, improvements in knowledge/information about health, chronic disease and well‐being, leadership opportunities, greater access to resources and increased peer support networks (Allen et al., ; Colleran et al., ; Downey et al., ; Ghahramani, ; Houlihan et al., ; James, ; John et al., ; Lazarus et al., ; Madrigal et al., ; Ramsden, Martin, McMillan, Granger‐Brown, & Tole, ; Schutt & Rogers, ; Woodall et al., ). Utilising a peer model also has benefits and advantages for the peer communities including actionable project findings/results applicable to the community, improved health and social services, enhanced understanding of community needs and priorities and increased awareness of important issues at community level, social change and justice (Baynes et al., ; Boise et al., ; Brown et al., ; Calhoun, ; Chen et al., ; Cortez et al., ; Dill, ; Downey et al., ; Gabriel et al., ). Furthermore, working with peers in a peer model can improve the quality of research, education and interventions in terms of recruitment, contextually and culturally relevant questionnaires, methods and techniques, data collection and screening, interpretation of results and translation and dissemination of findings (Chang et al., ; Horowitz, Brenner, Lachapelle, Amara, & Arniella, ; Hull et al., ; Martin et al., ; McElfish et al., ; Minkler et al., ; Olsson et al., ; Sharma et al., ; Topmiller, Zhen‐Duan, Jacquez, & Vaughn, ).…”

Exploration and Description of Faith-Based Health Resources

“…Interdisciplinary workforce development may need to emphasize faith-based aspects of holism, primary and secondary prevention, population-focused solutions, and community engagement such as those demonstrated in communities that are not overtly faith-based. 31 In addition, attaining and measuring quality for faith-based services may require a unified method. Four specific suggestions are offered as next steps forward in linking holistic health resources to a community-wide action plan for any county.…”