Community-Driven Development of an African Immigrant Community Health Worker Education Program in Philadelphia

Proposal:

Introduction: The success of community health worker (CHW) programs globally has led to their increased use within the United States. However, as these programs expand to serve new communities, development and implementation must be tailored to each community's needs to be most effective. Here, we present one approach, describing the community-driven development of a CHW program to serve the large African immigrant community in Southwest Philadelphia utilizing a mixed-methods Community Health Needs Assessment.

Methods: In order to engage the community in the development of health-focused educational programming, a mixed-methods CHNA was utilized. Semi-structured interviews and focus groups were conducted with community members and leaders. A survey (administered in English and French) was developed to verify themes identified in interviews. An ongoing CHW education intervention, the Community Healthworkers for African Migrants in Pennsylvania (CHAMP), involving the linguistic and cultural translation of CHW educational material and subsequent implementation in the community, was designed based on the data.

Results: The community was found to be highly engaged in the CHNA and training design efforts. Semi-structured interviews were conducted with 42 community members, and two focus groups were held. The resulting survey gathered 54 responses. This process revealed networks already functioning for health promotion in the neighborhood, including key individuals who functioned as informal CHWs. Respondents also identified important infrastructure that might otherwise be overlooked, like local stores and organizations, that functioned as community health resources. They also highlighted important accessibility needs for the training, such as language support for French and Arabic. Each of these findings was integrated into the CHW training program design process, ensuring accessibility and activating and integrating existing individuals and resources instead of attempting to replace them with a potentially redundant program.

Conclusion: Our findings demonstrate an effective approach to co-development of a CHW training program in partnership with an immigrant community, demonstrating a potential approach for further development of these programs in diverse, underserved communities around the United States.

Cristle Ike, Gabriela Montes de Oca, and Thomas Statchen are graduates from the University of Pennsylvania and co-leads of CHAMP. Each has extensive experience in community health and engagement, including work in community greening, anti-smoking promotion, and mobile health care delivery, respectively.

Kent Bream, MD is a Family Medicine Physician and the Associate Professor of Clinical Family Medicine and Community Health at Penn Medicine and has worked in building community partnerships and researching community medicine for over 20 years.