APPROACH AND METHODOLOGY
The NRHA will be conducting three training events in December 2011, April 2012, and July 2012 to help recruit and retain community health workers in rural areas of the US-Mexico border. The goal is to target at least 20 community health workers per training. Follow-up between trainings will be directed by the evaluation results from each training as well as conference calls to help maintain the network communications. Attendance for each training and each conference call will be monitored to assess the impact of each training.
Trainings will focus on workforce issues and communicable diseases along the border. Other potential agenda items include updates from federal partners, resources for community health workers, pressing issues/health concerns along the border, and coordinating across providers.
As the NRHA currently plans and conducts 8 education conferences and trainings per year, the association plans to leverage this expertise to help assist with increasing the access to healthcare information and treatment through a network of community health workers. The NRHA will work with its partners to access listings of community health workers in the area to help market the trainings and encourage new participation.
IMPLEMENTATION, TIMELINE, AND DELIVERABLES
- Trainings are being planned for December 2011, April 2012, and July 2012. At least 20 community health workers per training will be targeted.
- The NRHA will work in conjunction with the Federal Office of Rural Health Policy and the US-Mexico Border Health Commission to target participants and develop appropriate content.
- The number of new attendees as well as returning attendees will be monitored at each training. Evaluations will also be disseminated at each training to help gamer feedback on how to enhance the trainings and how to maintain involvement.
The US-Mexico border region is defined as the area land being 100 kilometers (62.5 miles) north and south of the international boundary. The area encompasses four US states (Texas, New Mexico, Arizona, and California), six Mexican states (Tamaulipas, Nuevo Leon, Coahuila, Chihuahua, Sonora, and Baja California), 48 US counties and 88 Mexican municipios. The majority of these US counties are considered rural and underserved. Rural populations, on average, have relatively more elderly and children, unemployment and underemployment, and poor, uninsured and underinsured residents. They are more vulnerable to economic downturns because of their less diverse economic base compared to urban counterparts (Ricketts et al, Rural health in the United States, 1999). Further, barriers unique to rural health care delivery systems include long travel distances to obtain health care, low population densities, lack of economies of scale and high rates of fixed overhead per patient revenue (Hassinger et al, Rural health care: Innovation in a changing environment, 1992). The nation's rural environment is diverse across its economic, social, environmental, demographic and epidemiological dimensions. Local health care systems, with small numbers of providers and sparse resources are tenuously balanced to meet the needs of residents while providing adequate income and quality of life to providers (Hart et al, Journal of Rural Health, 2002). An enduring characteristic of the rural health landscape is the uneven distribution and relative shortage of health care professionals (Hart et al, Journal of Rural Health, 2002).
These are stark realities along the US-Mexico border. With a healthcare workforce shortage crisis in place, the need for community health workers has become increasingly important. Oftentimes community health workers serve as the first line of healthcare access for individuals as they provide basic healthcare information and serve as a valuable community resource as well as assist with language barriers. The concept of enhancing a rural community health worker training network along the border would help to address some of these complex access to care issues.
The NRHA is proposing to expand the National Rural Community Health Worker Training Network to all of the United States. Private and federal funds are currently being solicited to offer additional trainings in different regions of the country. The trainings will be expanded to include rural providers to further enhance collaboration with CHWs thereby enhancing overall patient care. Trainings will cover leadership, communicable and chronic disease information.