What role does the national institutes of health play in community health?

The program aims to develop best practices for community health worker training, which will be helpful as medicine works to address care disparities.

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August 31, 2020 - A $2.3 million grant from the National Institutes of Health National Center for Advancing Translational Sciences will allow experts from Michigan Medicine, the University of Florida, and the University of California to conduct community health worker training.

The grant also funds research about best practice for future community health worker training.

Community health workers operate within the medical industry to address community health needs, as opposed to clinical health needs. They are frontline public health workers who address specific community and social health needs, help guide patients through the process of accessing social services, and serve as a liaison between the community and healthcare organizations.

“We know that community health workers are increasingly involved in research to engage individuals from underserved communities, and they make important contributions to the success of research in their community because they understand the socio-economic and cultural factors that influence it,” Susan Murphy, ScD, OTR/L, an associate professor of physical medicine and rehabilitation at Michigan Medicine, said in a statement.

But because community health workers are not necessarily clinicians — in fact, most experts agree peers who have lived experiences are best suited for the job as community health worker — there are a lot of questions about the training process.

READ MORE: How Community Health Workers Support Value-Based Care Principles

“We absolutely need their partnership and assistance to engage underserved communities in research, but we have also found that training for community health workers in research best practices varies,” pointed out Murphy, who is also a research health science specialist at the Veterans Affairs Ann Arbor Healthcare System’s Geriatric Research Education and Clinical Center.

The NIH grant aims to address those gaps in training, as well as help the three lead researchers identify best practices for future community health worker trainings.

“There are no national competencies for research best practices for community health workers,” according to Murphy, who also works as a faculty lead in the Education and Mentoring Group at the Michigan Institute for Clinical and Health Research (MICHR).

“This grant will allow us to enable community health workers to better support research within their community,” she says. “This is especially important in underserved communities where quality and translation of clinical research are hampered due to health disparities.”

The researchers have four main goals for this grant project.

READ MORE: Who are Community Health Workers, How Do They Treat Patients?

Foremost, they intend to provide a training and education service for individuals seeking to work as a community health worker.

Second, the researchers plan on having that training be culturally relevant for the community in which the workers will serve. This includes being linguistically competent, which is a key pillar for promotoras, or Spanish-speaking community health workers.

Third, the researchers want to make it easier for anyone to access community health worker training, ultimately removing barriers to this kind of training.

Finally, the researchers aim to empower community health workers to become “champions” of their craft. These champions can serve as peer mentors for other community health workers entering training programs.

“We believe this project will help to build an effective, community-engaged clinical research workforce and enhance research quality,” Murphy explained. “Which is a shift in the paradigm of training focused solely on clinical research professionals.”

READ MORE: Why Community Health Partnership is Key to Drive Health Equity

Understanding and delivering training for community health workers will be important given healthcare’s current climate. After the COVID-19 pandemic struck the US, it became clear that the illness did not affect all communities equally. Black and Hispanic patients were more likely to contract the virus and become sicker with it than their White peers.

This is not because Black and Hispanic patients were less able to fight the disease. Instead, it is because of the decades of institutional inequality and the social determinants of health that increased the odds patients would come in contact with the virus and have the chronic illnesses that exacerbate it.

Throughout the spring and summer, experts have identified community health workers as important for building up the cultural competency required to address health inequities. Community health workers can serve as the go-between for hospitals and traditionally marginalized communities, helping hospitals to deliver care in a more culturally competent way and hopefully close care disparities.

With community health workers potentially coming in higher demand, the researchers said it will be important to deliver and better understand training.

“The work of our team is also timely in that we hope to address the challenges and health disparities underserved communities are experiencing during the COVID-19 pandemic,” said Sergio Aguilar-Gaxiola, MD, PhD, director of the University of California Davis Center for Reducing Health Disparities.

The University of Michigan, University of Florida, and University of California will each serve as hubs for the training programs. Additionally, the University of Michigan will serve as the contact institution for the grant.

“Community health workers understand the needs of their community and are an incredibly valuable resource, especially when it comes to engaging their community members in research that could help us reduce health disparities in the future,” said Linda B. Cottler, PhD, MPH, FACE, a dean’s professor of epidemiology and director of community engagement of the University of Florida Clinical and Translational Science Institute.

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