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Bridging the Gap between Cultural Communities and Health Providers

Bridging the Gap between Cultural Communities and Health Providers: Peers for Progress Consolidates Research Findings, Discussions, and Directions

On June 17 and 18, doctors, health researchers, and other medical leaders convened at the Omni Hotel in downtown San Francisco with a common goal: presenting and promoting the evidence for the medical, social, and financial contributions of community health workers (CHWs) in diabetes prevention and management. Collectively, the attendees presented research that has been conducted across several countries in addition to the United States: Cameroon, Canada, China, Thailand, and the United Kingdom. The conference provided a productive platform for attendees to exchange ideas, discuss diabetes management methods within different cultural contexts, and identify how to best institutionalize CHWs within the health system without compromising their unique, localized contributions to their communities.

Peers for Progress and The National Council of La Raza (NCLR) jointly coordinated the conference as part of the National Peer Support Collaborative Learning Network. The Center for Health Law and Policy Innovation (CHLPI) contributed to the research by generating two white papers regarding CHWs and other non-licensed providers. The first paper, Affordable Care Act (ACA) Opportunities for Community Health Workers, generally explores the policy and legal framework underlying the ACA, which increases the role of CHWs within the US healthcare system. The second paper, Community Health Worker Credentialing, more specifically discusses different state approaches to recognizing and reimbursing their CHWs through both public and private insurance. While CHLPI has traditionally referred to non-licensed providers as CHWs, Peers for Progress applies the terminology generally as “peer supporters.”

The two-day program was divided into two structures of activity. On the first day, attendees broke into two groups in order to learn more about topics for which they had less prior knowledge. Two CHLPI students, Nina Souliopoulos and Qing Qing Miao, had the privilege to present CHLPI’s papers to conference participants. The day concluded with a dinner and rich panel presentation from CHWs of the Bay Area peer support programs who have applied their personal experiences from managing disease to helping other patients manage their illnesses.

The second day was a marathon event that alternated between presentations by Peers for Progress research grantees and discussions of the research, all of which were divided among three topics: (1) outcomes of applying peer support education and interventions in diabetes self-management; (2) challenges in peer supporters program development; and (3) the technological and cultural methods for diabetes management.

Personal highlights came from the introduction given by Ed Fisher, the Global Director of Peers for Progress. Mr. Fisher set the attitude for the conference, directing our attention to the very basic human function that peer supporters (including CHWs) serve within their respective communities. Patients with diabetes and other chronic illnesses might be able to access medication for disease self-management; however, without the support, guidance, and care of individuals with similar conditions to whom they can relate, patients cannot achieve a level of recovery as they would otherwise. “We like to be with, be around, have contact with, and engage with other people,” Fisher stated in reference to Harlow’s famous Reesus Monkey study that he presented along with his point about the human need for social interaction.

Another presenter was Justin M. Nash, Ph.D. in the Departments of Family Medicine and Psychiatry & Human Behavior at Brown University, who discussed an issue raised in CHLPI’s white paper, Community Health Worker Credentialing. “We need to be sure we don’t lose the uniqueness of the peer supporter and what the peer supporter brings to the community,” he emphasized, driving home the point that policymakers need to be careful to avoid setting standards and competency thresholds that exclude many effective peer supporters.

Lastly, Charlie Alfero, representing the Hidalgo Medical Center, honed in on the systemic dilemma underlying the previous presentations. “From what I have observed, the common theme across all the presentations is that the basic healthcare system – even…the stronger ones…lack adequate support.” Across different continents, the medical infrastructure for diabetes management will continue to operate inefficient and unsustainable models of healthcare until we collectively shift our model of care and support for patients. Community health workers, or peer supporters, seem to be one of the most promising avenues for this shift.

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