Parkland’s CHWs live, work in the communities they serve
Trust is key to community health workers’ success
Kena McDonald knows what it’s like growing up in a single-parent household and wondering where the next meal will come from. She understands that living paycheck to paycheck often results in juggling bills to determine which one gets paid and which one can wait. She knows first-hand the struggles members of her community face.
She knows, “Because I experienced the very same thing.”
As one of Parkland Health’s Senior Community Health Workers (CHWs), McDonald sees her neighbors cope with chronic health conditions, food insecurities and a lack of reliable transportation. She spends her days, and sometimes her nights, connecting people living in areas with the highest morbidity and mortality rates to the care and resources they need to live healthier lives.
Through Parkland’s Access to Care and Coverage program, CHWs travel to hubs developed in partnership with community-based organizations in areas identified by the 2019 Community Health Needs Assessment as having significant health disparities. The access to care program targets residents in ZIP Codes 75210, 75211, 75215, 75216, 75217 and 75241. It’s there that McDonald and her colleagues provide health screenings and insurance coverage assessments and connect them to resources so desperately needed.
In addition to working at the hubs, CHWs also connect with their patients through follow-up phone calls, and in the future hope to implement in-home visits where CHWs can conduct healthy home assessments that can help determine triggers for asthma and other chronic diseases. Still, because they live in the communities they serve, the trust that develops between CHWs and their patient is just as important as the health screenings they perform.
“Trust is a big part of what our CHWs bring to the table because they are leaders within their communities and they’re advocates for the neighbors,” said Vidya Ayyr, MPH, CHW, Director of Community Social Impact. “They are keenly aware of the struggles their neighbors face and because they have a shared degree of understanding, they’re able to help individuals navigate various systems and know where to go for answers.”
Finding answers, Ayyr said, can be frustrating when a person doesn’t know where to begin.
“For example, a provider might recommend that a patient switch from whole milk to almond milk not realizing the patient gets milk from the neighborhood convenience store,” Ayyr said. “That’s when a CHW can look at the care plan and see by taking the bus to the next stop they’re able to get what they need.”
Although Parkland’s CHW program has been in place since 2019, the pandemic forced the team to shift from in-home to phone visits. “Because we had already built the foundation, we were able to quickly pivot and continue to serve our communities,” Ayyr said, noting that the pandemic quickly shined a light on the strains the families endured.
As an example, Ayyr noted a family where both parents worked. Because of the pandemic, one of the parents was laid off and school for their three children went from in-person to online only. The perfect storm came together with emotional and financial strain coupled with homeschooling and even the lack of bandwidth for electronic devices.
“CHWs enrolled them in a free internet program and helped them in receiving SNAP [supplemental nutrition assistance program] benefits to address food insecurity. We also knew to administer mental health first aid,” Ayyr said. “We can recognize the signs and symptoms and talk them through issues until help arrives. We never know what we might come upon, that’s why it’s important that we give our CHWs the tools they need to be successful.”
CHWs, or promotores de salud, are certified by the Texas Department of State Health Services and must meet eight core skills competencies: communication, interpersonal, service coordination, capacity-building, advocacy, teaching, organization, and a knowledge base on specific health issues. In addition to the state’s 120-hours of training, Parkland requires an additional 160 hours of basic clinical skills so they can perform routine screenings such as hypertension and glucose screenings.
Still, the number one skill CHWs must possess is the ability to listen and truly hear what is – or isn’t – being said.
“I had a patient whose blood pressure was 160/200. When I asked how he was feeling, he said he was feeling ‘fine,’” McDonald said. “He was used to his blood pressure being so high, that it became his new normal. But knowing the dangers, we were able to immediately send him to Parkland’s Urgent Care Emergency Department where he was examined, put on medication and now his blood pressure is under control.”
The inability to read is another reality McDonald sees among her community. “They will bring their medications to the hubs and when we ask them to read what the prescription bottle says so we can determine if they’re taking their meds the right way, they’ll say ‘the writing is too small,’ or ‘I left my glasses at home’,” she said. “Until then, no one knew the patient couldn’t read because over the years they became experts at hiding it because they were ashamed. Well, we don’t judge, we help.”
But while there continues to be those who are having a hard time coping, McDonald said the best part of her job is when she’s reached out to an individual who was struggling only now to be told “I’ve got this.”
“And I know they do,” McDonald said.
For more information about programs at Parkland, please visit www.parklandhealth.org/connect.
To learn more about career opportunities at Parkland, go to www.parklandcareers.com.
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