Quiz: Is Your Community-Based Team Burned Out?

For most of us, a job with more independence; enough time to support staff, clients, and patients; and less stress would be ideal. But having this kind of flexibility when so many people need help is challenging. In fact, when stressors stack up, it’s easy for community health workers and promotores (CHWs/Ps) to reach a breaking point.

[Register now for Supporting Mental Wellness in CHW Teams]

Stress on the Job

Stress is a natural response to challenging situations. Low levels of stress are not damaging or a serious threat. In fact, a little stress can be a helpful motivator.

CHWs/Ps, healthcare workers, and in fact workers in most industries regularly face countless stressors. These can pile on top of daily stressors (divorce, sickness, financial difficulties) and anxiety-inducing world events … like pandemics.

But what happens when stress leads to exhaustion, a bleak view of your work and organization, and the loss of drive and interest in daily tasks? Burnout.

Burnout in Healthcare Providers

Burnout is when someone has reached a breaking point, they’ve lost control of the stress, struggle to keep up with work, and feel growing frustration. The World Health Organization recognized workplace burnout as a real condition in 2019.

Burnout on the job happens when someone runs out of physical, emotional, mental, and spiritual energy. It happens when they’re dealing with emotionally demanding situations for a long time. People report feeling burned out when they feel tired, frustrated, and like they’re not meeting their personal or professional goals. Burnout can happen especially when CHWs/Ps are feeling stressed.

CHWs/Ps develop strong bonds with clients and report that they feel fulfilled by their jobs. However, CHWs/Ps are often called on to respond to mental health crises but may not have the training to handle these challenging situations.

Many CHWs/Ps and their teams are often overworked, which contributes to growing frustration. Taking on so many responsibilities ups their risk of depression, anxiety, burnout, and compassion fatigue.

Another common source of frustration and discouragement is when a relationship they build with a client ends. The emotional roller coaster that comes with getting involved in the lives of their community — the people in their care — makes it easy to get attached and struggle with feelings like guilt, sadness, and even anger.

When your CHWs/Ps’ mental wellness is at risk, so are their clients. And so is your program.

If you work in a close team, you might be able to easily tell if someone is feeling undue stress. In our behavioral health course, we flag these as some of the items to look for if you suspect someone needs help.

Signs of Burnout

  • Sleeping too much or not enough
  • Sudden weight loss or gain
  • Avoiding people and activities
  • Smoking or drinking more, or using drugs
  • Mood swings
  • Apathy and calling in sick to work

In general, you can consider any big changes in everyday life patterns and habits a red flag among your team unless there’s a clear cause for them.

Whether you feel overwhelmed by tasks, trying to balance work and home, or just looking for ways to make your job better, here’s a quiz

you can take—or give to your CHW/P staff—to help determine if you should address burnout.

Quiz: Is Your Community-Based Team Burned Out or Stressed?

Ask your team members to select the answers that best apply to them.

1. Lately have you felt exhausted and frustrated at work?

2. Have you worried that your work is making you feel cynical?

3. Have you often felt down, depressed, or hopeless?

4. Have you felt overwhelmed or like you can’t finish all your tasks?

5. Have you felt anxious, depressed, or irritable?

6. Has your physical health declined, or have you been ill more frequently?

7. Do you believe that your work is not important or appreciated?

8. Do you find yourself simply wanting to escape by reading fiction, watching TV, playing video games, using substances?

Are You Dealing with Burnout?

If responses are mostly As, that could be full-fledged burnout. Even a single yes answer can indicate signs of burnout.

As a leader, you can create healthy work conditions, build a toolbox for your team to manage stress properly, and spot red flags that may point to hidden issues before your CHWs/Ps hit a breaking point. Help your staff to recover from burnout. A healthy, motivated staff makes all the difference in performance, job happiness, and overall wellbeing for your team and the people in your care.

Photo by energepic.com from Pexels

The Coronavirus Is Changing the Community Health Workforce. The Shifts May Be Here to Stay

Being a community health worker or promotora (CHW/P) now isn’t the same as it was in January. And the job might never be the same again. Public health departments, health plans, agencies, vocational high schools—all manner of health care systems in the United States are rethinking what it means to hire, train, and integrate CHW/Ps and other frontline health workers because of the coronavirus.

Since COVID-19 swept across the U.S., the many agencies and individuals are rethinking much of their CHW/P workforce: how new CHW/Ps are trained as they enter the job, what kinds of skills new and experienced workers need in a new health landscape, and even how they work as part of multidisciplinary healthcare teams.

[Ready for your next learning adventure? Start with CHWTraining’s Learning Tracks]

While some of the job changes are born out of necessity, some are simply a better way of working and connecting to clients and patients.

Here’s a closer look at three key ways in which the CHW/P job has changed and will probably stay.

In-Person Training Will Move Online

Virtual training is necessary because it’s not safe for many learners, trainers, and staff to safety travel to on-site locations. As time goes on, and as more health experts and communities warn that opening the country too soon could result in suffering and death, and critically for CHW/Ps, the ability to support underserved communities when they need it most.

The Washington State Department of Health usually offers in-person training across the state four times per year as part of its hybrid CHW training program. This year, however, just as the program was ready to offer its spring session, the state went on lock-down orders.

Washington is one of many organizations that say some or all training for CHW/Ps through the summer and fall is being provided online. Vocational high schools that train CHWs and other medical tech workers are also moving to an online format. We at CHWTraining have an entire team dedicated to creating a wide variety of courses and certifications to educate health workers no matter where they are so they can grow their careers.

CHW/Ps Will Use Telehealth

Telehealth, or telemedicine, is another domain that wasn’t part of many CHW/P tasks until recently. This is good news, because telehealth is a proven strategy to engage and support clients, especially those in rural communities. Now, most people are remote, and the same strategy of communicating with clients for long-distance health care and education works.

Exactly how CHW/Ps will use telehealth to connect with their clients is still evolving.

“Telehealth policy changes occurring within the COVID-19 environment have been rapidly developing on almost a daily basis,” according to Center for Connected Health Policy.

Some of the common ways telehealth is used, according to the Center, include:

  • Video conferencing in a live, two-way interaction between a patient and a provider
  • Store-and-forward technologies to transmit medical information, such as digital images, documents, and pre-recorded videos
  • Remote Patient Monitoring (RPM) to send personal health and medical data collection from a patient in one location to a provider in a different location
  • Mobile Health (mHealth) to support clinical and public health services and education on mobile devices such as phones and tablets
  • eConsult for providers to consult with specialists via live video conferencing or store-and-forward.

Skill Areas Will Evolve

Health education, outreach, referrals, and understanding health disparities are all important skills that CHW/Ps provide on a daily basis. Those are more important than ever in a pandemic. Prevention is essential to protecting the lives of people in low-income communities without adequate access to healthcare.

CHW/Ps, for example, can organize hand hygiene stations for homeless and migrant areas. They can use telehealth (see above) to check in with high-risk community members. They can keep people out of overused emergency rooms by teaching skills like understanding how to read and follow an asthma care plan.

Many CHW/P jobs include tasks no one ever imagined a few months ago – sometimes in ways they wouldn’t have thought of. The term “contact tracing” is something associated with CHWs during the Ebola crisis in Africa or cholera in Haiti, but wasn’t really practiced in the United States. CHW/Ps are working within their communities to map cases before it spreads.

Providing social support and behavioral health support are going to be even more important than before.

CHW/Ps Will Be More Integrated

Many healthcare systems that have considered using CHW/Ps, or use them but aren’t sure how they connect with the larger system, will need to change. These organizations’ workforces will need to understand the role of a CHW/P and how it differs from a social worker, case manager, or nurse. When disasters—health and otherwise—effect a community, it’s helpful to have a community-based workforce to minimize its impact.

“Right now there’s a focus on coordinating services for high-risk individuals to meet their health and social needs and help them remain at home safely to reduce their risk of contracting COVID-19,” Melanie Bella, chief of new business and policy at Cityblock Health and current chair of the Medicaid and CHIP Payment and Access Commission (MACPAC) said in an interview with Center for Health Care Strategies.

“States may want to consider re-focusing efforts on making system changes that increase coordination and alignment,” she advised.

Now more than ever before healthcare systems need to invest in CHW/Ps. They’re essential during pandemics and not.

 

Most Important Tobacco Cessation Skills for a CHW Training Plan

Tobacco kills and doesn’t have to. That’s why most health agencies already include dedicated tobacco or vaping cessation programs. They don’t, however, always include community health workers (CHWs) or other health promoters as part of that equation.

Need for CHWs on Tobacco Cessation

CHWs are proven through multiple studies to provide significant impact on health promotion and disease prevention, including tobacco and vaping cessation. They excel at prevention strategies, and tobacco use is the leading cause of preventable mortality in this country. And CHW initiatives can excel where clinic-based programs fail: CHWs know their communities and can reach more underserved and hard-to-reach smokers, such as LGBTQ+ communities.

“Tobacco use is twice as high for LGBTQ+ high school students than for heterosexual students,” says Mandi Pratt-Chapman, director of the GW Cancer Institute, on Twitter. 

Tobacco programs across the world that use CHWs have demonstrated promising quit rates. A study from the CDC shows community-based interventions included are cost-effective. Another study shows that people working with CHWs were about three times more likely to quit when compared with a control group.

Thankfully, guiding people to stop smoking or vaping is an accessible skill. CHWs who have the right kind of training and supervision can work within a community to provide culturally relevant motivational strategies, social support, and bridge gaps in healthcare.

[Read more: Online Training Beginner’s Guide for Program Managers]

Any tobacco and vaping cessation program should include not only clinicians, clinical staff, and also community-based health workers with the knowledge and skills they need to promote tobacco cessation.

Where To Start with Tobacco Cessation Training Programs for CHWs

Before designing your tobacco cessation program, assess your needs. You could start with a skills gap analysis. This analysis, or assessment, is an important first step in creating any online training initiative. Establishing what stakeholders need from a program, and what your trainees need to learn, will help you create a program that has a greater chance of success.

But too many people either skip the step of creating a needs assessment, or they make mistakes. If a training needs assessment is messy, it could set the tone for your entire program, and could leave unsatisfied health workers or wasted funds.

To do your own skills gap analysis, list the essential skills in a CHW tobacco training program (some suggestions are below), check off the areas where you already excel, and note areas where you need extra support. Then, rank each CHW based on these criteria to find out who needs to learn which skill.

Sample Gap Analysis Template

Competency

Importance

Rating

Comments

1.

 

 

 

2.

 

 

 

3.

 

 

 

4.

 

 

 

Don’t forget to include your CHWs and healthcare team. Ask what they’d like to learn more about, and involve them in designing a tobacco cessation training program that dovetails with additional training opportunities. Any training and development program works best when the people you’re training are involved.

Then, you’ll be ready to decide what portions of your training program you want internal, and which you can outsource to a program like CHWTraining. An outside education consultant can supplement your team by helping you build a training plan and conduct these analyses. A cloud learning subscription can make your training much more successful by being accessible 24/7 and allowing CHWs to train remotely.

Tobacco Cessation Training Guide

When you’ve defined which training areas you can address internally and which you’d like to outsource, then you can put together a program. Here are some of the skills CHWTraining recommends as part of a tobacco cessation and vaping program.

  1. Tobacco Cessation
  2. Vaping
  3. Motivational Interviewing
  4. Communication Skills
  5. Outreach Skills
  6. Cardiovascular Disease
  7. Providing Social Support

1. Tobacco Cessation

An overall course on tobacco cessation will show your team what motivates people to use tobacco or vape and what resources are available to help them stop. An ability to make smart recommendations that help people live a healthier life relies on understanding factors that can help or hinder cessation attempts, as well as several strategies that tobacco users can employ to work towards their cessation goals. (Check out 10 Free Apps for Tobacco Cessation.)

2. Vaping

New information appears regularly on severe lung disease associated with using vaping devices and e-cigarette products. Vaping should be a focus of any tobacco control program, especially among youth.

This is a bigger program than you might think, and vaping leads to smoking. The Washington State Department of Social and Health Services posted on LinkedIn, “One in five 10th graders in Washington uses vapor products or e-cigarettes … each year in Washington, approximately 1,800 youth start smoking & will continue smoking into adulthood.”

Training on vaping should include what the products are and how they are used, effects on brain and lung development, addiction, pathways to tobacco use, and understanding how tobacco and vape marketing intentionally target low-income communities.

3. Motivational Interviewing

Motivational interviewing (MI) is a technique used to help people discover their own reasons for positive change in a non-confrontational way. It was originally developed as a way to help people quit smoking, and while MI techniques can be used for helping people make any kind of behavioral change, it’s still an essential skill for stopping smoking.

4. Communication Skills

Frontline healthcare workers need to be able to understand the language used on a daily basis to provide education and motivation for quitting tobacco or vaping. Using good communication techniques helps them relate health information better, limit misunderstandings, and build trust. Include a course that provides foundational communication techniques to facilitate better communication between health care providers and community members, and it will be useful in many different settings.

5. Outreach Skills

Any tobacco cessation program should be built on solid outreach and engagement skills so that community members know what resources are available to them.

An outreach skills and engagement course should provide a path that goes through identifying a target audience, determining their needs, and spreading the word about smoking cessation services or programs that will benefit them.

6. Cardiovascular Disease

Smoking takes a toll on the heart, so CHWs should understand how in a training about cardiovascular disease. A good course on CVD should cover how the cardiovascular system functions, what happens during a heart attack and stroke, as well as how smoking can lead to worse outcomes. Skills in this course should also include management and prevention strategies that will include using cigarettes and e-cigarettes and well as other negative influences.

7. Providing Social Support

Learning to navigate social situations and building a support system is critical for dealing with a quit attempt and motivating patients for change.

A providing social support course will provide positive stress management and coping skills, ways to strengthen social support networks, and interpersonal and relationship-building skills.

Related: Chronic illness education and training for teams

Health photo created by freepik – www.freepik.com

Asthma Awareness Best Practices

Allergy season is a tough time for everyone—especially people with asthma.

Helping community members manage asthma is more important now than ever before. Supporting patients with asthma and their caregivers can keep people out of the emergency room (ER) and also help keep their lungs healthy in case of a complication, such as COVID-19.

Asthma affects approximately 20 million people in the United States. According to the American Lung Association, asthma is one of the main reasons that students miss school due to illness. Making a few changes can significantly change those statistics.

Frontline health workers can have a much higher success rate helping their clients follow asthma action plans, understand their medication, and avoid (or minimize) an attack in the future by following a few best practices. It can be as easy as sharing a few key pieces of knowledge—even if you don’t have a dedicated asthma care team.

Click here to read more about chronic illness training.

Changes that work for people with asthma or their caregivers don’t have to be about major lifestyle overhauls. They can be as simple as a few steps and a little careful planning. It comes down to showing clients how to recognize asthma symptoms, identify and use asthma medications, and reduce asthma triggers in the home.

It’s also helpful to remember that asthma education isn’t a one-and-done activity. Community health workers, promotores, and other health educators should take the time to build relationships so they can communicate best practices to their clients over time.

To that end, read on for essential asthma awareness best practices that apply to any healthcare agency, especially now in allergy season.

5 Asthma Awareness Best Practices

  1. Prepare for COVID-19
  2. Push for asthma training for CHWs
  3. Understand the asthma action plan
  4. Remove shoes at the door
  5. Ventilate the house

1. Prepare for COVID-19

Asthma is one of the underlying health conditions that can increase people’s risk for serious case of COVID-19, the disease caused by the coronavirus. This doesn’t mean they’re more likely to get an infection, but they are more likely to have worse outcomes if they become sick with COVID-19.

Also, hospitals are a bad place to be right now. People with lung conditions are more frequently admitted to hospitals because of their illnesses.

The best thing frontline health workers can do is help people stay home, keep a safe distance from others, and avoid getting sick in the first place. They should stay connected with their healthcare providers about any symptom changes. And, of course, follow the asthma action plan.

2. Push for Asthma Training for CHWs

Many healthcare agencies and systems don’t realize CHWs can be an important source in home-based asthma care, which can directly and significantly help the agency. Without the right training, CHWs won’t be able to help. So push for training in courses like CHWTraining’s Improving Asthma Outcomes or other courses.

It’s even better if these training programs are part of standard CHW requirements. Minnesota, for example, requires a field-based program that can involve an asthma care team. Washington state also recommends asthma continuing education for graduates of its community health worker training program.

Working in asthma treatment goes deeper than just knowing what asthma is and how to control it. It should be part of a comprehensive training program. Other supplemental skills should include:

3. Understand the Asthma Action Plan


Healthcare providers give people with asthma an asthma action, or management, plan to control the disease. The goal is to prevent or reduce flareups and limit trips to the ER. Not everyone understands their plan, which is where CHWs can help.

They can help interpret the instructions on the plan and make sure it’s in a place that can be accessed when it needs to be during an emergency. CHWs can also help patients and their caregivers understand proper inhaler technique and connect to the right professional if needed.

4. Remove Shoes at the Door

CHWs are effective where their clients live, which is where most people deal with asthma each day. They can help as soon as they arrive at the door with this simple technique: take your shoes off.

One of the easiest ways to reduce triggers and allergens in a client’s home is to ask everyone to remove their shoes before they go inside. It’s so simple and costs nothing—just take them off before going inside. It’s also a good way to make a pair of shoes last longer.

When someone walks around outside, their shoes collect dirt, molds, fungi, pesticides, and anything else on the ground.

The coronavirus can travel on shoes too, although scientists are unsure if the droplets were still infectious. A study from the CDC shows the virus can survive on shoe soles.

5. Ventilate the House


Indoor air quality has a big impact on how well someone can manage their asthma. An efficient ventilation system with clean air filters helps, but it can be expensive. People who live in apartments might not have control over the ventilation system either.

An easy and free solution is to keep air from outside coming in. The best way to ventilate the house is to go to every window, and open it. When every window has been opened, start over and close each one. That gives the house enough time to ventilate without letting in too many allergens.

To learn more about educating clients about asthma, contact us to sign up for Improving Asthma Outcomes.

Survive Distance Learning Talance

Oral Health Training Initiatives in Every State

It’s well documented that oral health is connected to the whole body. So, it makes sense for CHWs and health promoters to understand why oral health is important and what to look out for when visiting clients. Many agencies recognize the need to include oral health in CHW training.

Some states, such as Oregon and Minnesota, require CHWs to take training in oral health.

To help your program meet any requirements or support initiatives—and improve oral and overall health outcomes in clients and patients—we did a deep dive into each state to see what they offer in terms of oral health training, requirements, and resources for CHWs.

Do you know of anything we left out? Let us know, and we’ll add it to this list.

Oral Health CHW Training Initiatives by State

Alaska

The Alaska Community Health Aide Program (CHAP)/Dental Health Aide Program (DHAP) complements Alaska’s tribal health care system to ensure access to primary health services in remote frontier communities serving Alaska Natives.

Arizona

Arizona has a state Oral Health Action Plan that includes a strategy to “engage other health professionals (physician assistants, nurse practitioners, community health workers (CHWs), to help consumers navigate the healthcare system.”

Arkansas

The Arkansas Department of Health includes a STAR.Health initiative that use CHWs to promote health in maternal-child health, oral health, and chronic disease management.

California

The California Oral Health Plan includes a strategy to “Provide technical assistance and training to support the inclusion of oral health goals in promotora/community health worker (CHW) programs and home visitation programs.”

Colorado

Colorado doesn’t specifically recommend oral health training by CHWs but it does expand the role of dental hygienists to include some traditional CHW skills, “Colorado allows licensed independent dental hygienists to provide preventive care and refer for restorative treatment.” The state does include standards and requirements for health navigators—sometimes called oral health patient navigators–on “Recognizing and reporting abnormal signs and symptoms of common conditions including mental and oral health.”

Connecticut

Connecticut is showing some signs of requiring oral health training for CHWs by integrating oral health with medical health.

Delaware

Delaware is committed to training CHWs in oral health by training with a presentation called “An Inside Look into the Connection Between Oral Health and Overall Wellness,” from the Division of Public Health at Delaware Health and Social Services. It also has an “Oral Health 101” presentation. “We also encourage the Smiles for Life educational resources,” says Gabrielle Hilliard, the public health treatment program administrator at the Delaware Department of Health and Social Services’ Division of Public Health.

Florida

The Florida Senate issued language addressing “critical shortages of providers” in oral health care, among others, and is encouraging CHWs to plug that gap. The Florida Oral Health Alliance works with the Florida Community Health Worker Coalition to work toward its oral health plan.

Georgia

Georgia was one of 13 states working on state guidelines for instituting best practices for oral health access.

Hawaii

Hawaii was one of 13 states working on state guidelines for instituting best practices for oral health access.

Idaho

The Idaho Oral Health Network carves out space for CHWs to help with oral health. Idaho also was one of 13 states working on state guidelines for instituting best practices for oral health access.

Illinois

Illinois was one of 13 states working on state guidelines for instituting best practices for oral health access. Its action plan includes, “Increase oral health services (diagnostic, preventive, and restorative) to Medicaid and SCHIP children, birth through 13, by 14 percent.” It received a HRSA grant to build up an oral health workforce.

Indiana

The CHW Workgroup includes an initiative for “diagnosis-related patient education towards self-managing physical, mental, or oral health in conjunction with a health care team.”

Iowa

Iowa was one of 13 states working on state guidelines for instituting best practices for oral health access.

Kansas

Kansas does not yet have established CHW requirements but does have many areas of specialty, including oral health as well as diabetes, asthma, and others, according to Oral Health Kansas. Kathy Hunt, Dental Program Director, says “Next steps are to offer supplemental specialty courses (on-line and face to face) after graduation that will best match job placement,” including CHWs who will work in oral health.

Kentucky

We were unable to find details on CHWs and oral health in Kentucky.

Louisiana

We were unable to find details on CHWs and oral health in Louisiana.

Maine

We were unable to find details on CHWs and oral health in Maine.

Maryland

“Maryland had just begun its process to accredit CHW Certification Training Programs and has not yet issued any accreditations,” says Kimberly Hiner, deputy director of the Office of Population Health Improvement at the Maryland Department of Health.

“Maryland’s CHW certification process is built on our CHW core competencies.  While oral health is not explicitly listed as a core competency, training programs may have it incorporated into their comprehensive curricula. We should have more information within the next six to twelve months.”

Massachusetts

Oral health is offered as a special health topic to be potentially taken for the CHW requirement course, and/or offered as a potential course for the CHW Certification Renewal.

Michigan

Michigan was one of 13 states working on state guidelines for instituting best practices for oral health access.

Minnesota

Minnesota initiated an expansion of its oral health workforce because more than half of its counties are considered Dental Health Professional Shortage Areas. Minnesota’s 2013-2018 Oral Health Plan details strategies to expand the oral health workforce to reduce these disparities, including using CHWs.

Mississippi

Some CHWs in Mississippi have completed oral health training, according to Tameka Walls, director of the Mississippi Delta Health Collaborative at the Mississippi State Department of Health.

Missouri

CHWs in Missouri do not currently receive training regarding oral health, but “we are considering options to encourage this training,” says Karen Dent, Director of the Oral Health Network of Missouri at the Missouri Primary Care Association.

Montana

Montana encourages training in oral health for CHWs but has no posted requirements.

Nebraska

The state Health Worker training program does not offer training in oral health, but the state has used CHWs in the past and has placed some individuals in the training program.

Nevada

CHWs who are not certified or who have the first level of certification in Nevada, need the basic state-approved course. “There’s 20 additional hours of required ‘general training,’ which is not prescribed and CHWs can certainly submit trainings that were on oral health,” says Kayla Valy, project manager for the Nevada Community Health Worker Association. “Oral health trainings are likely to be approved for the ‘general’ category but not specifically called out anywhere.”

The Nevada Certification Board has information for people who would like details on the requirements and process of becoming a certified CHW.

New Hampshire

New Hampshire encourages training in oral health for CHWs but has no posted requirements. The Oral Health Program at the New Hampshire Department of Health and Human Services has some information about oral health initiatives.

New Jersey

New Jersey has no posted requirements and did not respond to our survey, but the Children’s Oral Health page at the State of New Jersey Department of Health lists some educational resources.

New Mexico

New Mexico was one of 13 states working on state guidelines for instituting best practices for oral health access.

New York

“Will test a model that uses family-level, peer-counseled, and technology-assisted behavioral risk reduction strategies, aims to divert children with early- and advanced-stage early childhood caries (ECC) from high-cost surgical dental rehabilitation (DR) to low-cost non-surgical disease management (NSDM). Together, parents and community health workers (CHWs) will use MySmileBuddy (MSB), a mobile tablet-based health technology, to plan, implement, and monitor positive oral health behaviors, including dietary control and use of fluorides, which arrest ECC’s progression.”

Oral health for CHWs as part of Maternal and Infant Community Health Collaborative.

North Carolina

North Carolina supports community dental health coordinators. “CDHCs are dental assistants or dental hygienists with the combined skills of a community health worker, dental auxiliary, and care coordinator who are recruited from the vulnerable community they will serve,” according to a newsletter from the NC Department of Health and Human Services.

North Dakota

North Dakota is working on a Community Health Dental Coordinator program supported by the state Dental Association, the ADA, and other partners. “There are a few in North Dakota who have taken the training, and are working in the state (though community health workers/Community health dental coordinators do not yet provide care that can be reimbursed – this is a conversation that is being had with state Medicaid),” says Shawnda Schroeder, the oral health expert at the University of North Dakota School of Medicine and Health Sciences’ Center for Rural Health. “The state has just begun to have conversations around dental community health workers and there is consensus among oral health providers and stakeholders that this model could work in North Dakota.”

Oregon

Oregon’s Traditional Health Worker (THW) program requires applicants to complete between 1.5 and 3 hours oral health training.

Pennsylvania

The state pledged to “develop programs that promote and support oral health careers” to meet a gap in promoting oral health education in its Pennsylvania Oral Health Plan 2017-2020 (PDF). This includes “comprehensive plan to improve the number of oral health professionals graduating and remaining in Pennsylvania.”

Rhode Island

Rhode Island has requirements for becoming a certified CHW, and while CHWs aren’t required to complete oral health training, they are required to include a “portfolio”: a collection of personal and professional activities and achievements in categories that can include oral health. The state’s Oral Health Program is a “mini-residency” that increases career opportunities for oral health professionals and access to the marginalized communities.

South Carolina

Oral health is a specialty track that the South Carolina Community Health Worker Association would like to provide to CHWs. It is an area that trainers in the state are looking to include in the future.

South Dakota

Delta Dental of South Dakota, which covers over thirty‐thousand isolated, low‐income, and underserved Medicaid beneficiaries and other American Indians on reservations throughout South Dakota, received an award to improve oral health and health care for American Indian mothers, their young children, and American Indian people with diabetes.”

Tennessee

The Tennessee Department of Health made October 2019 Child Health Month and published a toolkit full of resources for health workers (available here as a cached resource).

Texas

Certified CHWs in Texas should be trained in oral health principles as part of the core competency Knowledge Base on Specific Health Issues. It includes the objective, “Find information on specific health topics and issues across all ages [lifespan focus], including healthy lifestyles, maternal and child health, heart disease & stroke, diabetes, cancer, oral health and behavioral health.”

Utah

The Utah Department of Health’s Office of Health Disparities publishes many resources for community-focused workers and program coordinators, including “Seal Your Smile: A Step Toward Combatting Oral Health Disparities in Utah,” “Cross-Cultural Education and Training: Oral Health Education Institutions in Utah,” and “Addressing Oral Health Disparities in Urban Settings: A Strategic Approach to Advance Access to Oral Health Care.”

Vermont

Vermont offers a few initiatives focused on improving oral health (PDF), especially in rural areas. A major achievement is “Access to oral health care was a top priority identified in our current CHNA. In response a multi-agency Rural Oral Health Access initiative was launched to provide oral health screening and dental hygiene services to children in elementary schools throughout our HSA and to link these children to a dental home.”

Virginia

Virginia’s action plan includes increasing utilization of dental services. Virginia Health Catalyst has resources surrounding its initiatives for CHWs.

Washington

The Washington State Department of Health has many resources and trainings for community health workers focused on oral and dental health. The Community Health Worker Training project includes a course available to Washington participants on oral health, available in English and Spanish.

Wisconsin

The Wisconsin Oral Health Coalition released “Roadmap to Improving Oral Health 2020-2025” to reduce the prevalence of oral disease and reduce disparities in oral health status among populations but doesn’t contain specific information about CHWs.

No information was available for Alabama, Delaware, Ohio, Oklahoma, West Virginia, or Wyoming.