Indiana is home to communities that face barriers to employment, financial instability, and lack sustainable self-sufficiency. Significant inequities and health disparities persist despite existing efforts. A group of faculty from Purdue University has engaged a variety of community partners throughout Indiana in an effort to eliminate health disparities for marginalized communities through the Community Health Workforce Development Institute.

Initial aims of the Institute are to create and sustain Community Health Worker (CHW) jobs for members of vulnerable neighborhoods in Indiana and help communities overcome barriers to employment and other poverty-associated challenges.

CHWs build individual and community capacity by increasing self-sufficiency and health knowledge through a range of activities such as outreach, community education, informal counseling, social support, and advocacy. CHWs improve clinical outcomes for chronic and other health conditions that disproportionately impact African American and Hispanic populations. CHWs in Indiana are currently supporting efforts related to maternal-infant health, diabetes, tobacco cessation, mental health, and more!

Core CHWDI team
Core CHWDI team: Yumary Ruiz, Carly Kimiecik, Jasmine Gonzalvo, Lola Adeoye-Olatunde, Natalia Rodriguez, Ashley Meredith (left to right)

 

Nationwide, CHW models exist with varying degrees of implementation, breadth, and sustainability. Indiana lags behind the progress made for the CHW workforce in other states. Indiana currently has siloed CHW programs and scattered models of CHW training and employment, and the workforce has generally been under-recognized and underutilized. Access to certified training programs is limited, which presents a challenge to the low-income communities who would most benefit from CHW employment opportunities and service provision. In previous years, a Governor’s CHW Workgroup laid much of the foundation for the progress made to date. The Institute aligns and builds upon existing efforts, envisions and develops innovative solutions, and aims to improve health outcomes for and lift up marginalized individuals and communities out of poverty.

An overview of our work was presented to the Indiana Rural Health Association in February 2021 and can be viewed here.  Our 2020 Needs Assessment Report, including Key Findings and Recommendations, can be found here.

CHW Development
 

  1. Provide core competency-based CHW training for identified community members
  2. Provide sector-specific skills training (i.e. research skills, and other focused training as identified by needs assessment)
  3. Path to CHW certification and career development opportunities

Sector-based Workforce Development

Create employment opportunities for CHW trainees in three sectors:

  1. Academic sector: Core group of university-employed CHWs as faculty research partners
  2. Community-based sector: CBO-based sustainable CHW employment for community outreach and social service delivery
  3. Clinical Sector: Healthcare facility-based sustainable CHW positions to support clinical care efforts

Provide guidance and support to:

  • design CHW-led scopes of work (SOW)
  • incorporate CHWs into existing SOW to increase outreach capacity
  • navigate reimbursement models
  • increase funding opportunities
  • Effective supervision, peer support, and career development

 

Evaluation and Policy Advocacy

  1. Conduct rigorous evaluation of Institute outcomes, including changes in CBO/Clinic agency capacity to recruit, hire, and retain CHWs, and CHW impact
  2. Evidence-based policy advocacy:
    • Formal integration into health sector
    • CMS/FSSA reimbursement for full set of CHW services
    • Essential critical infrastructure workforce definition

 

CHW development institute graphic

 

Partners

Academic: Purdue's Extension Health and Human Sciences (HHS) & Economic and Development Programs, Office of Engagement, Center for Health Equity and Innovation, Indiana University School of Medicine and Center for Global Health, Fairbanks School of Public Health, Indiana Clinical and Translational Sciences Institute (CTSI), Indiana Alzheimer Disease Center, Health TechQuity Lab, Center for Rural and Migrant Health
Clinical: Eskenazi Health, HealthNet, Gennesaret Free Clinics (GFC)
Community: Indiana Community Health Worker Association (INCHWA), Young Men's Christian Association (YMCA), Local Initiatives Support Corporation (LISC), Purdue Polytechnical High School, Purdue Policy Research Institute, Purdue Center for Regional Development (PCRD), CICOA Aging and In-Home Solutions
Governmental: Family and Social Services Administration (FSSA), Indiana Department of Health (IDOH)