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10 skills CHWs can learn right now—without leaving the couch

Use at-home time to brush up on existing skills or pick up some new ones.

The now-global spread of coronavirus is affecting everyone. This disease has brought a host of medical, economic, and political problems. It’s brought all of us—CHWs, supervisors, program managers, clients, and patients alike–a ton of uncertainty and anxiety. This can have an enormous impact on everyone’s emotional and physical wellbeing.

Whenever you’re feeling unsure and anxious about the things you can’t control, it can be helpful to focus on the things you can control, such as your education. While you or your staff might be stuck at home or in a quiet facility, the Internet is still on. So rather than panic-scrolling through social media feeds about toilet paper, put that energy into picking up some new skills or improving the ones you already have.

[Related: The 27 New Skills You Can Now Learn on CHWTraining]

10 Skills CHWs Can Learn from Home

They say there is no such thing as useless knowledge. These 10 skills are definitely worth learning—and learning them can make time based at home time well spent. In the future, these skills form a great workforce development path and can make each CHW a better worker.

  1. Meditation and mindfulness techniques
  2. Depression, Anxiety and Stress
  3. COVID-19
  4. Smoking cessation
  5. Chronic illness
  6. Immunizations
  7. Motivational Interviewing interventions
  8. Healthy cooking
  9. Hand hygiene
  10. Language

1. Meditation and mindfulness techniques

Relaxation and mindfulness are skills that can help you in your personal and professional life—especially now when everything feels uncertain. Mindfulness practices can help people manage stress, deal with serious illness, and reduce anxiety and depression, according to the NIH. These are helpful skills to pass on to clients, employees, and the people around you.

“The most important thing to know when starting a meditation or mindfulness practice is that there is no right or wrong way to ‘do’ it,” says Laura Wells, a facilitator and coach who works with individuals, teams, and organizations to increase focus and build compassionate leadership.

“It is simply about learning to relax into the present moment — there’s nothing we have to, or can, ‘do’ to make the present moment happen. This is about allowing the space for a minute or two or five to not be in charge of what’s occurring. Simply breathing and bringing attention to what is already here in our experience.”

If you want to practice now, you can join Wells for a free 30-minute virtual meditation and connection session Tuesday, Mar 24, 2020, 12:10 PM Pacific Time. Click here to join and use meeting ID: 144 588 211.

2. Depression, Anxiety and Stress


Nearly everyone is feeling depression, anxiety, and stress right now, so it helps you and anyone you work with if you can pick up management skills. Start by recognizing the symptoms of depression from the National Institute of Mental Health.

Then what to do if you see them in yourself or in another. This guide will help you understand when it’s time to make a behavioral health referral.

Supervisors and program managers supporting a community health team with limited resources can easily feel overwhelmed. You have to think about self-care strategies to share, how to help them control stress, and spot signs of burnout and compassion fatigue.

Sign up for Supporting Mental Wellness in CHW Teams, a free on-demand session on improving your team’s mental wellness, identify signs that an employee is at risk for depression, anxiety, or secondary trauma, and show you how you can help your team improve their personal and professional lives.

3. COVID-19

If you’re looking to learn more about coronavirus, then the WHO is the place to start for any health professional. The OpenWHO Massive Online Open Courses for COVID-19 provide learning resources for health professionals, decision-makers, and the public. As the pandemic continues to evolve, new resources will be added, additional language versions will continue to be rolled out, and existing courses will be updated to best reflect the changing context. Some sample courses are “Operational Planning Guidelines to Support Country Preparedness and Response” and “Infection Prevention and Control.”

4. Smoking cessation and vaping


People with unhealthy lungs are particularly at risk for complications from coronavirus, and many other health issues. Learning about these risks can help you talk clearly to clients who smoke. There’s plenty of new information regarding severe lung disease associated with using vaping devices and e-cigarette products, so now is a time to learn about that, especially among youth.

“There are many websites, webinars and listserves available for folks to learn the latest on commercial tobacco and vaping,” Says Norilyn de la Peña, Cessation and Outreach Project Manager at Public Health — Seattle & King County. It’s important to seek resources that are credible. People want information on what vaping products are how to have effective conversations about their use. She suggests learning about these tobacco cessation and vaping education topics for all providers:

  • What the products are and how they are used
  • Why it’s important to keep flavored tobacco and nicotine from youth (affects on brain and lung development, increase chance of addiction, increase likelihood of tobacco use, etc.)
  • Media literacy and tobacco and vape marketing intentionally target low-income communities
  • The importance of sharing valid information from appropriate online resources
  • How to talk to young people about vaping
  • Alternatives to nicotine and tobacco use; positive stress management and coping skills
  • What resources are available

She recommends the following general resources:

  • Truth Initiative
  • AAP (American Academy of Pediatrics)
  • SAMHSA (Substance Abuse and Mental Health Services Administration)
  • SCLC (Smoking Cessation Leadership Center)

Public Health — Seattle & King County’s website has Lung disease related to vaping and e-cigarette use. It has an excellent collection of materials, templates, and FAQs for providers, partners, and schools on understanding vaping and how it affects the lungs.

5. Chronic illness

CHWs are vital to successfully managing and avoiding chronic illnesses such as diabetes, heart disease, breast cancer, and cervical cancer. Since CHWs are health brokers who can connect providers with communities, take some time to learn more about the chronic diseases in your community and how CHWs can help.

If you’re a program manager or administrator new to CHWs, do some deep reading on building the policies and systems that support CHWs to see how they fit in with your organization. Start with the excellent document “Addressing Chronic Disease Through Community Health Workers: A Policy and Systems-Level Approach,” (PDF) from the CDC. Then take some time to watch Examining Community Health Worker Models in Managing Chronic Conditions.

If you’re a CHW, you can learn how chronic illness and mental health are closely linked. This video Ask an Expert – Depression and Chronic Illness Webinar (1:19) explores the relationship between depression and Nephrotic Syndrome, specifically, but the topic relates to people living with many chronic diseases.

CHWs can also save on CHWTraining’s chronic illness bundle. It helps you master working with clients with breast cancer (Breast Cancer Screening), cervical cancer (Cervical Cancer Screening and HPV), Diabetes and Prediabetes, and High Blood Pressure (Hypertension). Along the way, you’ll learn how to screen for disease, talk to clients, and connect to resources in your agency and community.

6. Immunizations


Parents and individuals are too reluctant to get vaccines, thanks in part to too much mistaken information. Patient education is an important way to let people know that vaccinations have an excellent safety record and are an important part of preventing serious diseases. A simple flu shot, covered by many health plans, is the best way for people to protect themselves and their children from getting the influenza.

The AAP is an excellent resource for educating parents and any individual on immunizations. It includes the recommended immunization schedule, information for parents, and communication tips for the conversations you’ll have with parents.

7. Motivational Interviewing interventions

Motivational interviewing (MI) is a technique you can use 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, but MI techniques can be used for helping people make any kind of behavioral change.

Demonstration and practice are the best ways to learn and improve your MI skills, so spend some time reviewing some sample intervention videos, such as these:

8. Healthy cooking


Nutrition and health are closely related, from a healthy diet helping children grow up to avoid chronic diseases to managing—and maybe even reversing—conditions like diabetes. Learning healthy cooking is an excellent skill you can pass on to your clients, and your own family.

Try My Doctor – Kaiser Permanente, which has many how-to videos, ranging from short-and-sweet lessons like Add Flavor Without Salt (2:33) for hypertension, to Tips for Cooking Healthier (2:01), to in-depth webinars like Fresh Food Ideas (1:01:00) for parents.

9. Hygiene

Time to get serious about hand hygiene. Learn, demonstrate, repeat.

10. Language

Communication is a key skill for CHWs, and being able to speak and understand more than English helps. Learning a foreign language, such as Spanish for English-speakers or English for Spanish-speakers, is a great way to unlock better employment options and connect clients to resources.

Smart phone apps like Duolingo are great vocabulary builders, and you can do them whenever you have a few free minutes. Another fun one is Lirica, which matches language with pop music. It takes the music from such musicians as Enrique Iglesias and turns it into Spanish vocabulary and grammar lessons.

Keep building skills

Just reading a PDF or a PowerPoint presentation isn’t enough to really learn. Practice your skills as soon as you can. Keep refreshing your skills once you’ve learned something. Bookmark this page so you can keep revisiting these resources and keep them fresh.

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.

5 Easy Ways To Keep Learners Motivated [Infographic]

5 Easy Ways To Keep Learners Motivated [Infographic]

The hard truth about investing in training for your team is that there’s no guarantee they’ll like it. You certainly hope that they find the elearning program they take to be engaging, immediately applicable and better able to connect with the people in the community.

But that’s not always what happens.

And while you can brush that off when you didn’t invest too much time in the curriculum—like when you just hand them a PDF—it stings a little more when it’s something more resource-heavy like an online training program.

Luckily, there are few things you can do in your training initiative to hedge your bets. We put together the following infographic on making highly engaging learning programs — helping you keep learners’ eyes open and keep improving health outcomes in your community. Follow these tips, and your team will be much more likely to finish, and be glad they did.

Want to use some of techniques with your team? Contact CHWTraining to start right now.

Building a Healthy Habits Challenge: What Works and What Doesn’t

The team at CHWTraining might know all about developing and keeping healthy habits, but that doesn’t mean we always do it. Even for people in the health education business like us have habits we’d like to change: stopping smoking, drinking less alcohol, drinking more water, eating less meat, eating fewer sugary foods.

This January, our parent company Talance wanted to encourage this kind of change internally instead of just for our clients and course participants. Here’s what happened.

First, we researched several workplace wellness challenges to find a format we liked. This article on Health.gov, 7 Simple, Fun Wellness Challenges to Start At Work, had some ideas we liked.

Importantly, we wanted people to control how they participated. We teach many people about behavior change with techniques like Motivational Interviewing, and we all know that no one will change anything unless they’re inwardly motivated to do so. We wanted to tap into intrinsic motivation as well as extrinsic motivation. NBC’s Better explains it well in this article 3 types of motivation that can inspire you to do anything.

Setting Healthy Habits Goals

Armed with some ideas, we decided to create a challenge that affirmed any positive change that anyone wanted to make. However, because cutting back on smoking is the single best thing anyone can do for their health, we wanted to especially encourage any smokers to cut back or stop. The 31-Days-Free Challenge was born.

The 31-Days-Free Challenge was open to anyone who wanted to participate in one of two ways:

Title: Challenge description - Description: No Smoking Challenge: Stop smoking or cut back.Put Something Else in Your Mouth Challenge: Don't smoke? Pick something you DO or DO NOT want to do that will improve your health (drink water, quit drinking, cut out sugar).

From the start, everyone was very interested in curious about the challenge. But as time went by, fewer people decided to participate. We would have loved everyone to join, but creating new habits is tough. It has to happen on an individual basis—not just because there’s a challenge there or because it’s January 1. So we hope to catch more next time.

We were left with a core of four who signed up and stuck with it for the whole month. Here’s what our challenges looked like:

Anastasia

Title: goal - Description: My challenge: Smoke not more than 5 cigarettes per day for 5 days/ week. Don't smoke at all for 2 days/week.

Monique

Title: Goal - Description: “Reduce alcohol consumption in January from 5 units to 3 units by drinking only on weekends (Friday, Saturday, Sunday).”

Pamela

Title: Goal - Description: “I will reduce the sugar treats (cake, cookies, chocolate, ice cream, candies) + junk food (that's a long list including diet soda) from almost every day to *1 serving per week*.”

Peter

Title: goal - Description: “Eat vegetarian for 8 days in the month (about 2 days a week)”

We’re All Winners Here

There were no losers in this challenge–only winners. So we designed a system where every week participants would self-report how they did based on the achievement points (see the full list below), which were added to a scoreboard. During the week, we opened our internal chat channel (#31-days-free) to advice, reports, tips and encouragement.

This is what a typical week looked like on the scoreboard:

What Worked and What Didn’t

The result? It worked! Everyone who participated made improvement. Most people kept to their goals for the whole month, or at least got close. We all felt better physically and also had fun as a team in a different way that wasn’t related to a project.

As Anastasia said, “For me, it was important that we did it as a team, and that each week I had to say how I was [doing] and state specific achievement points.”

As planned, our chat channel was busy with reports, encouragement and recipes. It was empowering to see how everyone was working toward their goals and how they were navigating barriers. We were all in the spirit of helping each other succeed.

And as expected, there were some unforeseen holdups. For example, my challenge, which required me to cut out my dinnertime glass of wine most nights, didn’t take into account a mid-week birthday celebration that included champagne. So next time, I know to build in some flexibility.

This is a good lesson for anyone who doesn’t reach their goal, whether it’s someone with type 2 diabetes trying to cut down on sugary foods or someone who’s looking to control substance use. Failure can be valuable. It teaches you what your limits are and reveals obstacles that you can navigate next time.

Smokers know this too. Quitting is hard. Slip-ups are inevitable and can be discouraging. According to one study, “it may take 30 or more quit attempts before being successful.” But each slip-up is a learning experience. Note it, what caused it, and keep moving.

There were also some problems with the format. It felt too much like a competition to some. Anastasia said, “Competition didn’t work for me. I wanted to help and learn from the others so I couldn’t see it as a competition.”

There were also some logistical hiccoughs. About halfway through the month, we noticed that some people were making excellent progress but not earning any achievement points. We added a “fill-in-the-blank” point to use whenever you’re doing well but aren’t fitting the list of points.

Next time, we’ll probably forget any points and instead focus on supporting healthy habits only. Importantly, there will be a next time, and many of us are still sticking with our new healthy habits even past January. Hello, flexibility challenge!

Wellness Achievement Points

Here were the achievement points we awarded, which you can copy for motivating your group.

General Points

  1. Post your SMART goal to #31-days-free
  2. Put yourself on the scoreboard
  3. Help someone on  #31-days-free stay on goal
  4. Share a tip on #31-days-free for staying on challenge
  5. Stick to your challenge for 1 week for 1 bonus point
  6. Stick to your challenge for 2 weeks for 2 bonus points
  7. Stick to your challenge for 3 weeks for 3 bonus points
  8. Stick to your challenge for 4 weeks for  4 bonus points
  9. Recruit one person in your life to do your challenge with you
  10. Find a team partner
  11. Meet your challenge goal on both Saturday and Sunday
  12. Walk around the block instead of doing something you’re trying to stop
  13. Set your health goal for February
  14. Meditate
  15. Suggest an achievement point (if it gets enough thumbs-up, you
    get a point, and we’ll add it to the list)
  16. Distract yourself by doing a good deed for a few minutes

No-Smoking Points

  1. Go 1 day without smoking
  2. Try Nicotine Replacement Therapy (NRT), such as Nicorette gum, patch, lozenge
  3. Get a Chantix prescription
  4. Walk past the tobacconist
  5. Play with your phone rather than smoke
  6. Remove all ashtrays
  7. Look up number for local quitline
  8. Call quitline
  9. Set a quit day
  10. Download a quit app to your phone (QuitNow! for Android or QuitNow! for Apple)
  11. Read a quit smoking book
  12. Give money for a pack of cigarettes to a trusted friend or charity for safekeeping instead of buying one (count how much you have on Feb. 1)
  13. Attend a support group, such as https://stepbac.com/ or https://www.icoprevencio.cat/uct/en/quit-smoking/
  14. Try an alternative therapy, like acupuncture
  15. Take smoking cessation class
  16. Go to a smoke-free zone when you feel like smoking

Put-Something-Else-in-Your-Mouth Points

  1. Download a healthy eating app to your phone (food log, exercise log, no drinking log)
  2. Walk 1000 steps (or 1/4 mile or 1 km) instead of putting That Thing in your mouth
  3. Get a pedometer
  4. Cook a new healthy recipe (share it on #31-days-free)
  5. Skip meat at 1 meal
  6. Have a meatless Monday
  7. Eat 5 servings of produce in a day
  8. Drink a glass of water instead of a glass of wine
  9. Drink 8 glasses of water in a day
  10. Walk somewhere instead of driving/taking a taxi/metro
  11. Create a healthy grocery list
  12. Try one new healthy food you haven’t tried before
  13. Read a healthy eating/cooking book
  14. Take a cooking class that meets your challenge
  15. Plan a weekly menu (post it here!)
  16. Instead of putting That Thing in your mouth, chew a stick of gum