Darlene Shearer, DrPH, Principal Investigator/Director MCS-WFD

1. THE MATERNAL AND CHILD SERVICES WORKFORCE DEVELOPMENT PROGRAM: Using Advanced Training and Expanded Roles to Enhance Home Visiting Darlene Shearer, DrPH, Principal Investigator/DirectorMCS-WFD The Lawton and Rhea Chiles Center, University of South Florida Estrellita “Lo” Berry, MA, Director/Principal Investigator Central Hillsborough County Federal Healthy Start Project Tampa, Florida

2. BACKGROUND Community Health Workers: • A new name for home visitors, family support workers, outreach workers • Seeking a new image • Unique skills that a valuable to address health disparities • Gaining wide acceptance nationally • Worker training, support, utilization and value is anything but uniform

3. MCS-WFD PROGRAM PURPOSE • Develop a credit-earning education program • Increase competence and job performance of non degreed workers who provide maternal and child services • Target workers in public health, child development, and family support programs:Home Visitors, Family Support Workers, Outreach Workers, and other Human Service Workers

4. PROGRAM DEVELOPMENT • DACUM SESSION a facilitated analysis of worker duties, tasks and behaviors • FOCUS GROUPS What workers get out of their current training: “Sometimes we go to 8 hours of training. Out of 12 points that are discussed endlessly there might be one little thing that we actually take away with us and use.” “I have enough attendance certificates to wallpaper my entire house. What has all this training gotten me?… absolutely nothing!” What workers identified as needed in a training program: “I think we don’t get enough training on how to fill ourselves back up after caring for our families.”

5. COMPETENCY AREAS Addressed by the MCS-WFD Program • Family Relationships • Prenatal, Postpartum and Newborn Care • ReproductiveHealth and Family Planning • Infant and Child Development • Environmental Influences on Health and Growth and Development • Screening, Assessment, Planning and Implementation of Preventive Interventions and Health Education • Nurturing Environments • Adult Learning Principles • Professionalism

6. COURSEWORK for FHSW Certificate ATD Diploma for Family Health and Support Workers Health 1 Health 2 Field Placement Field Placement And Practical And Practical Applications Applications (1.5 Hours) (1.5 Hours) MCH 1 MCH 2 MCH 3 Working with Families in the Early Childhood Period Working with Families Principles for Under- standing and Working with Families In the Perinatal Period: (3 Hours) (3 Hours) (3 Hours) Generalist 1 Generalist 2 Generalist 3 Introduction to Basic Communication Cultural Diversity Human Services for And Interpersonal And Implications Families and Young Skills For Practice Children (3 Hours) (3 Hours) (3 Hours)

7. PROGRAM EVALUATION • Individual Level • Agency Level • Client Level

8. STUDENT DEMOGRAPHICS (n=42) • Race White 19% Black 50% Hispanic31 % • Age group 21-30 17% 31-40 43% 41-50 28% 51+ 12% • Marital Status Married 54% Single 46% • Highest level of high school 12th grade 79% GED 21% • Highest Level of College Completed No college 29% 1-2 years 66% 3 or more years 5%

9. AGENCY APPLICATION Changes in Workers, Their Roles, and the Work Environment

10. CHHS Career Ladder Model for Community Health/Outreach Workers • Tier I Indigenous workers who function in Quality Assurance role. Responsible for administering satisfaction surveys, recruiting women into MCH services and participating in Community Health Boards, activities. ATD graduate can carry maximum caseload of 3 to 5 families (GED, High School, College). • Tier II • Perinatal Support Outreach Workers-responsible for provision of case management to CHHS participants, and • Community Outreach Workers- recruitment, administer satisfaction surveys, participate in Community MCH activities (ATD Program). • Tier III Senior Level Outreach Workers who serve as Community Health Worker Trainers for CHHS and other Community Based Projects (College).

11. Theme…… “Quitting is not an option”

12. Elements of a Successful Community Health Worker (CHW) Project Model • Upper management promoting acceptance of CHW’s valued role • Nurturance • Accountability • Successful attitude • Effective supervision

13. Criteria for Participation as a CHW/Outreach Worker • Indigenous to the community we serve • Ability to connect with families • Familiarity and comfort with neighborhoods and service population(s) • Satisfactory job performance

14. What CHHS Wanted Out of the Joint Venture with the MCS-WFD Program • Sharpened communication skills of CHWs • Increased self esteem and self confidence of CHWs • Increased knowledge and skill set of CHWs • Increased competence and proficiency of CHWs • Increased partnerships to build community capacity to reduce maternal and child health issues

15. BENEFITS • Generalization and application of knowledge in CHWs personal life • Systemic change (valuing para-professionals) • Enhanced interpersonal skills among CHWs • Enhanced intrapersonal skills among CHWs • Stronger team partnership among CHWs

16. SECONDARY GAINS • Extended pride among family members • Enhanced supervisory skills • Garnering additional funds to increase outreach worker salary by 10% • Promotion of continued academic development beyond ATD • Promotion of career focus

17. LESSONS LEARNED • Be prepared for jealously among other team members • Be prepared for benign neglect • Be prepared to spend more time job coaching and mentoring • Be prepared for extensive time allocation