How I Started a Community Health Initiative and How It Can Make Your Clients Healthier

Finding fitness, friendship, and lifestyle change on the road to community health

By Eliana Ifill

One of the hardest parts of doing physical activity is finding the confidence and motivation to start. It’s intimidating to make a big life change, and it can be easier to push it to the side.

People like community health workers (CHWs) and promotoras know how limiting this is. They see how older people and those who stay home live in isolation unless they take an intentional approach to improving their social lives. Inactivity can lead to all sorts of health problems, according to the American Heart Association, including heart disease, high blood pressure, obesity, stroke, type 2 diabetes, depression, cancers—and more. Active living is a topic we cover in many of the elearning courses at CHWTraining.

Public spaces also take a hit when individuals stay home: parks and streets are empty, and smaller roads can be neglected by local authorities. This makes it even harder for community members to step outside and take charge of their health.

[Related Community Engagement the Right Way with Outreach Skills]

In my case, I live near an industrial area. It was bustling with activity during business hours. But come 5 p.m. the roads were empty, the lights didn’t work, and the police had long left the streets.

Collaborating for an Active Community

I had come home to Venezuela after living in the U.S. for a while and didn’t have a steady job or other activities where I could meet people. This, combined with some personal challenges, made me start thinking about forming a fitness group of some sort. After all, I’ve been involved in one sport or another since college. Integrating physical activity as part of my daily life has always been important to me. And the lack of activity mixed with all the life changes and all the time spent at home was really taking a toll on my mental health.

I ran into (pun intended) another neighbor with a similar idea: She and her husband had made drastic lifestyle changes, and along with a friend they decided to try and promote sports in our small community.

I found them on Twitter and we decided to try forming a community running group design a short route around our neighborhood. We started very small–just the four of us–and soon, a lot of neighbors started joining us to run three times a week.


Eliana’s running group after a run.

How success spread across the community

We found that the safety and comfort provided by group activities helps keep people accountable while they build a habit for themselves, especially in older communities. Running with others is a powerful motivator.

Group activity like ours helps neighbors connect over shared interests; bond in new, meaningful ways; and regain confidence, purpose, and happiness in their lives.

My running group reached close to 80 people running together on Tuesdays, Thursdays, and Sundays.

The demographics were wildly varied: there were a few of us in our early 20s, some in their mid-40s, and quite a few in their 60s and 70s. The younger ones often led the pack, going back and forth on our routes ensuring everyone was OK and no one was left behind.

And we had some experts: A trainer who led our warmups and HIIT classes on the weekends; a hiker who led our expeditions through the nearby mountains, and some yoga instructors. There was one man, Manuel, who worked in security for our community association and coordinated the team’s safety throughout the route, reminding everyone to bring reflective clothing, carrying radios and flashlights, and always counting heads before we left and after coming back.

We gathered local support and had police escorts on our routes, made T-shirts for the group, showed up in some radio interviews, and worked locally with churches and other initiatives.


Eliana’s running group in the orange T-shirts they had made.

Of course, the physical benefits were great. It was especially exciting to see those over 50 finishing their first races, shaving off minutes between 10ks, trying out yoga and hiking for the first time.

Many of the participants remain active to date (the group started in 2015 and Venezuela’s crisis made many of the original members move to other countries). Many of us remain close friends. We celebrated birthdays, went to theaters, had holiday parties, and supported each other through races and beyond.

More than simply exercising, we’d built a community based on friendship and common goals.

Skills to Motivate Lifestyle Change

CHWs and promotoras who work in neighborhoods that don’t lend themselves to physical activity can follow my lead and still make a difference. Training programs can provide the key skills they need to make meaningful change, especially among clients with chronic illnesses or high utilizers of emergency rooms.

[Related Build Skills in These 3 Areas To Stop Diabetes Killing People]

It helps to understand how healthy eating and active living (HEAL) programs fit into health conditions like HIV/AIDS, diabetes, heart disease, and others. But to build a program that can lead to community change, here are some of the most important skill-building courses any agency should provide to their staff:

Promoting Healthy Lifestyles

Practicing healthy behaviors has a huge effect on a person’s life. Knowing the concepts behind maintaining a well-balanced and healthy lifestyle is the place to begin to work with clients to make positive changes and mange their life. The knowledge of what a healthy lifestyle is, including nutrition, fitness, preventative healthcare, and behavioral health, helps learners instruct clients on how to make a change for the better.

Community Outreach and Engagement

Outreach is the most essential part of building and strengthening communities so the people who live in them can take advantage of everything available. By learning the basic concepts and skills in community outreach, as well as strategies such as community needs assessments, learners can promote and even create better health services.

Advocacy Skills

Advocacy Skills demonstrates ways to use advocacy to connect people to the most important resources in organizations, but also externally. They also learn how to involve the community at large in clients’ issues, educate community members, use media and social media, and organize change.

Motivational Interviewing: Peer Support for Behavior Change

Before anyone changes their health, they must want to. Training in Motivational Interviewing helps people find the lasting motivation to improve their health internally. These skills are especially useful for promoting healthy lifestyle changes, managing chronic diseases, and setting goals.

Behavioral Health Care

Physical activity has a close relationship with mental health. Understanding this relationship, as well as what the most common behavioral health conditions are, can help clients find resources and build external structures that help them improve.

Eliana Ifill is a content manager at CHWTraining.

CHWTraining Releases New Course for Under-served Communities: “Oral Health Disparities”

Online training offers guidance for community health workers, case managers, and others to bridge gaps in oral-health awareness and access

Woburn, Mass., Feb. 14, 2020 – CHWTraining, a trusted provider of educational support and structure that enables organizations to build healthier communities from Talance, Inc., has added the new online course “Oral Health Disparities.” The 2- to 3-hour self-guided training is designed for people who need to show clients and caregivers how to improve oral health while navigating social determinates of health.

Oral Health Disparities,” available in English and Spanish, is ideal for clinical and non-clinical staff, including community health workers, promotoras de salud, case managers, patient navigators, support staff, and more.

Many people in the United States fail to understand the profound relationship between oral health and overall well-being. The mouth can show signs of nutritional gaps or general infection. Poor oral health reduces quality of life and is related to chronic systemic conditions, including stroke, heart and lung disease, and diabetes.

But significant disparities remain in oral care across different populations, where oral-health literacy can be negatively affected by factors ranging from race and ethnicity to socioeconomic status, geography, culture, language, gender, and age.

According to the Centers for Disease Control, non-Hispanic blacks, and Mexican Americans between 35 and 44 years of age experience untreated tooth decay nearly twice as much as white non-Hispanics. Latino children have higher rates of tooth decay, rampant decay, and treatment need compared to non-Latino white children. Many people living in less-affluent urban and rural areas either can’t afford dental insurance or face other barriers—including language, culture, or a lack of available information and resources—to finding and receiving oral care. Poor dental health in under-served communities can correlate to chronic conditions ranging from heart disease to diabetes to brain degeneration and more.

However, oral disease is preventable with the proper training. Oral Health Disparities helps employers, health systems, agencies, and health departments invest in training that promotes prevention and coordinates care among at-risk patients.

The course provides oral-health training and support for healthcare workers on various oral-health aspects, including teaching clients the basics of good oral care and dietary choices, learning to recognize oral signs of health or substance-use issues, and helping to bridge gaps and barriers to quality care.

About CHWTraining

CHWTraining provides online training-technology tools to organizations that want to create workers who transform health in America’s communities. It’s perfect for training new employees who need core competencies or standardizing training for existing staff—on their own time. The assessment-based certificates confirm that participants can demonstrate their knowledge.

About Talance

At Talance, we believe we all have a civic responsibility to help build healthy communities. Since 2000, we’ve collaborated with educators, advocates, health practitioners, governments, and employers to drive positive, lasting change in the environments where people actually live and work. Talance delivers online community-health education that is trusted by clients across the nation, who rely on our expertise to help develop custom curricula or tap into our original course library that is developed by a professional team of industry leaders.

Interested in educating your team in oral-health disparities? Contact us to learn how at www.chwtraining.org/contact.

CHWs Can Improve Oral Health Disparities

People who work with people’s teeth understand what kind of view that provides to the whole body. They see first hand how the mouth can reflect problems around the body and how problems with the mouth can affect the rest of the body. Poor dental health can correlate to chronic conditions ranging from heart disease to diabetes to brain degeneration—and more.

Almost all Americans understand this first-hand. Over 90% have at least one tooth that’s been treated for decay or needs to be. About a quarter of U.S. adults between 20 and 64 need a filling. Cavities are the most common chronic childhood infectious disease. Periodontal disease is also tragically undertreated in the States and affects about half of us. The problem there is that people with gum disease are 2 to 3 times more likely to have cardiovascular problems.

Oral Health Disparities

Access to health care and proper education helps address this gap, but there are stark disparities in the oral health of men, women, and children. These oral health disparities can have serious consequences, which we explore in depth in the CHWTraining course Oral Health Disparities.

Learn more about how CHWTraining Subscriptions can help increase CHW/promotora satisfaction, retention, and improve oral health outcomes

Some of the statistics from our course are unsettling.

“Blacks, non-Hispanics, and Mexican Americans aged 35–44 years experience untreated tooth decay nearly twice as much as white, non-Hispanics,” according to the CDC. Latino children have higher rates of tooth decay, rampant decay, and treatment need, compared to non-Latino white children.

Image: Pew Charitable Trusts

Education is widely lacking. I, for one, have never once in my life been told that women have unique oral health concerns, despite regular checkups and experience with recurring canker sores and inflamed gums. Are most pregnant women told they are far more likely to have gum disease or loose teeth or that morning sickness is a problem for teeth? I’m guessing not.

The trouble is that too few of the people in charge see it that way. Starting from the top with health policy all the way down to children who haven’t learned to brush regularly, too many people are tuned out to the connection between oral and overall health.

Many people can’t afford dental insurance or expensive electronic toothbrushes or a house where the water is fluoridated, especially in underserved rural and urban areas. Still, there isn’t much care coordination and patient navigation to support people.

Fortunately, this trend is reversable because relatively simple prevention goes a long way with oral and overall health.

CHWs Can Reverse Oral Health Disparities

Communities and health systems need to step up oral health by providing better access to dentists and education. Community health workers (CHWs), promotores de salud, and other lay educators are in a perfect position to help.

States and health systems should work to include oral health education as a part of CHW training. They can help people navigate such barriers as poverty, language, geography, and even transportation. And they can do it where people live, not necessarily in a clinical setting. This is a relatively low-cost way to engage families but can have a tremendous impact a person’s health, from childhood through the rest of their life.

Interested in educating your team in oral health disparities? Contact us to learn how.