'You're a bridge. You are the community.'
How OHIO-trained community health workers connect with and care for the people in their region.
Acadia Hansen, '26 | March 14, 2024
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Jessica Carter worked as a chef for 15 years before becoming a community health worker (CHW) in Southeast Ohio. After completing her coursework in 91探花鈥檚 CHW program, Carter works closely with new mothers, helping them focus on the importance of good nutrition. When an issue arose in a client鈥檚 kitchen, she knew just what to do.
鈥淚 had a couple of clients who didn鈥檛 know what to do with a whole chicken,鈥 Carter explains. 鈥淎nd I was like, I didn鈥檛 even think about that. I didn鈥檛 even think that you wouldn鈥檛 know how to cook a whole chicken.鈥
The job description might not include cooking expertise, but the ability to draw on life experience and community connections to solve problems is a crucial skill for all CHWs. And then there is what Carter said next to her clients.
鈥淟et鈥檚 walk through it together. We鈥檒l do it right now,鈥 she recalls telling them. And that鈥檚 exactly what she did.
Walking through it together
Community health workers may be employed by public or private organizations and their job descriptions vary widely, but one thing is true of all CHWs: their work focuses on bridging the gap between healthcare and people.
The CHW title is newer than the job itself. Associate Professor Kerri Shaw, community health worker lead for the OHIO Alliance for Population Health, says that similar roles鈥攍ocal healthcare liaisons and advocates鈥攈ave been around for hundreds of years. The significance of such work is not always recognized; nor has it always had a name.
鈥淭his is a new term in the United States to some degree, but really, they鈥檝e been naturally in communities around the world for a long, long time,鈥 says Shaw. 鈥淭he people who kind of established this title in the United States, they were physicians who went up to Alaska and found these really rural Alaskan communities that all had local health leaders who were very trusted.鈥
Increased recognition of the role鈥檚 importance from the larger healthcare community has brought increased demand for CHWs. This recognition led to the creation of 91探花鈥檚 training program in 2015. In 2019 the offered a $1 million grant, which allowed the University to expand the program to help fight the opioid crisis. The program has also been adapted to train lay community members in Ukraine to support their communities.
鈥淚 love being able to look at the people in my classroom and know that they are going to be treated with dignity and respect and that they鈥檙e getting jobs.鈥 Associate Professor Kerri Shaw has seen OHIO鈥檚 Community Health Worker program's enrollment grow from three students when the program started in 2015 to a current average of 40-60 students each semester.
CHWs often work closely with their own communities, which makes them better able to advocate for their patients because they understand them on a deeper level and may share similar experiences with them.
鈥淚t鈥檚 pretty integral to the position that they look and talk like and have lived experience that is really similar to the people they鈥檙e working with, which is unique in the healthcare world,鈥 says Shaw. 鈥淚 think that having that voice, that community voice, in healthcare is a game changer because you get to advocate from a first-person experience.鈥
Carter, the former chef, now works as a certified community health worker and a state-certified peer recovery supporter. She works with patients from Jackson, Gallia and Meigs counties, driving an average 200 miles a day delivering food and other necessities to her patients.
鈥淚 was able to help one of my clients get a vehicle and it was a life-changing moment for them,鈥 Carter says. 鈥淚t鈥檚 something so very basic, just having transportation, and she cried and was just so appreciative. It鈥檚 the little things like that.鈥
It鈥檚 compassion and empathy and actually treating people like they鈥檙e human beings.
Each CHW brings a different set of life experiences to the role, and they鈥檙e encouraged to let those experiences inform their practice. Carter often uses her experience as a chef to educate her clients about making the most of the food she delivers.
鈥淚f they don鈥檛 know how to maybe prepare some of the things that are in their food boxes, they can call me and we can work on recipes together,鈥 Carter says.
A single mom, April Krape finished her CHW training recently and is in the process of completing her field hours at her current job. She spends her days working with families in Washington Courthouse.
鈥淚 was just recently able to help someone get a new washer because it鈥檚 a household of seven and their washer quit,鈥 Krape says. 鈥淥n that same day I was able to deliver Thanksgiving food. It鈥檚 challenging sometimes, but very rewarding.鈥
Better health outcomes
91探花鈥檚 Community Health Worker training is one of the few free CHW training programs offered in the state. The course is extensive and covers 100 hours of coursework. The majority takes place online, with three in-person classes. The in-person classes include CPR certification and training in basic medical tasks such as taking vitals and motivational interviewing, a conversational approach to patient intake that helps CHWs understand their clients鈥 behaviors and assess how motivated they are to make changes.
鈥淎fter students complete the 100 hours in the classroom or doing didactic activities, they will then complete 130 hours in a community-based setting, practicing community health work,鈥 says Shaw.
During this time, students work closely with a supervisor and complete journals reflecting on how they apply their classroom learning to what they are doing in the field. Students are eligible for certification through the Ohio Board of Nursing after completing the required field hours.
His CHW training inspired case worker Christopher Johnson to take his own healthcare more seriously.
Christopher Johnson graduated from 91探花 in 2018 with a degree in stage management. Johnson lives in Logan, where he works at Health Recovery Services as a case manager while completing the CHW coursework. He counsels clients who face addiction and mental health issues. Johnson said his experience with the CHW training has not only had a positive impact in his work, but also in his personal life.
鈥淭he training is fun,鈥 says Johnson. 鈥淚鈥檝e found it more and more helpful, not just in my work life, but in my personal life. I have high blood pressure, so going to classes and hearing that high blood pressure can be catastrophic and can be deadly really inspired me to watch over my own health more.鈥
Olivia Degitz is another alumna of OHIO鈥檚 CHW program. Her background is in social work and public affairs; she even studied neuroscience as an undergraduate.
鈥淚t鈥檚 a very accessible course to folks,鈥 Degitz explains. 鈥淲e had a really diverse group of people in our class which I loved. It was all women, and we had women from all over the state with various backgrounds, various ages, and I thought that was really cool. I learned a lot from my classmates.
Degitz recently moved back to Athens, where she works at the Athens City-County Health Department as the Friendship Bench program manager. The program offers free and confidential appointments with staff trained to lend a listening ear.
鈥淭he training is more accessible than you might think,鈥 Degitz adds. 鈥淚t is more useful and more helpful than people realize. Folks who are community health workers play a huge role in the health and wellbeing of our communities, and in helping folks have better health outcomes in general.鈥
"You're a bridge."
Appropriate healthcare is vastly important for everyone, but not everyone has the same access to it.
鈥淲e get to really be addressing health inequities in a new way,鈥 Shaw says. 鈥淲e shouldn鈥檛 be saying that people are non-compliant because they don鈥檛 have transportation to their doctor鈥檚 appointment.鈥
No matter the specifics of their day-to-day jobs, all CHWs work to bring healthcare to communities in an accessible way.
鈥淭he training is really easy for the people that set out to do this type of work with very little bias,鈥 Carter says. 鈥淵ou can walk into someone鈥檚 house knowing that they have bed bugs and you treat them like they鈥檙e a human being. That鈥檚 what it is. It鈥檚 compassion and empathy and actually treating people like they鈥檙e human beings.鈥
I think having that voice, that community voice, in healthcare is a game changer because you get to advocate from a first-person experience.
Building trust is vital for a good healthcare experience, but trust is difficult to establish when there is little to no common ground between patient and doctor.
鈥淓specially here in Appalachia, where we are not very trusting people, we don鈥檛 trust our doctors,鈥 Carter says. 鈥淲e鈥檙e not going to go because we have the cold or a flu, we鈥檙e not going to the doctor. I think it鈥檚 important for our role as CHWs to actually gain that trust and that rapport with our clients so that they might be a little more apt to actually listen to us.
Shanika Frazier has worked as a CHW for five years. Previously, she spent fifteen years working in child welfare, and was a foster parent for six years. After completing her CHW training and becoming certified, she got a job with United Healthcare.
鈥淲hen they say community healthcare, you鈥檙e a bridge. You are the community,鈥 Frazier says. 鈥淏ecause you bridge that gap and then the health workers are your peers, the people that you work with. And we鈥檙e all working for one goal. And that is that: every person, we meet them where they are and we get them what meets their needs.鈥
Looking forward
鈥淚 love being able to look at the people in my classroom and know that they are going to be treated with dignity and respect and that they鈥檙e getting jobs,鈥 Shaw says. 鈥淭hat鈥檚 what we need in our region.鈥
The first cohort had three students. Now the program enrolls between 40 and 60 CHWs each semester. Community health work is a growing field, one that is based on empathy, trust, and care.
鈥淵ou know,鈥 Frazier says, 鈥淚 don鈥檛 think I鈥檒l ever stop doing work in the community to help people bridge the gap.鈥
Individuals interested in 91探花鈥檚 Community Health Worker Program can apply online. The program is offered each semester at different 91探花 campuses.