The Importance of Integrating Community Health Workers into Traditional Practice

The integration of community health workers into traditional health care practice has been a hot topic for many years, according to Rosalia Guerrero-Luera.

“This idea to certify or not to certify, has always, for a lot of people, been one of those make or break questions,” Guerrero-Luera, a project manager at University of Texas School of Public Health, said in an interview with CURE®. “Every state is different, and every industry is different within the medical field. But that question always seems to weigh on people.”

Guerrero-Luera, who recently participated in Susan G. Komen Greater New York City’s Annual Patient Navigation Conference, spoke with CURE about what it means for community health workers to be certified, as well as the role those individuals play in the care of patients with cancer.

CURE: For those who may not know, what does it mean for community health workers to be certified or not?

Rosalia Guerrero-Luera: Historically, community health workers have always been a non-traditional health worker. These are folks that come from the community and are people that have life experience. I kind of call them “friends with benefits”, because it could be anyone. They don’t have to be in the health care field, but it is someone who always seems to be in tune with what's happening in society as far as health care and social services. They don't go through the traditional route of going to medical or nursing school, nor are they an LPN or social worker. They're literally coming from the community. But over the years, the health care industry has seen that community health workers play a very important role.

Where does the community health worker fit on the spectrum of being noted as a professional and what does that mean?

Certification is a process where a community health worker or a person in the community can say, “I've taken a step towards being a professional. This is what I do for a living”. They’re no longer just the neighbor. For the healthcare industry, always having a certification provides them with the confidence that they're bringing someone into their organization that has some understanding of the medical field, of health literacy, and they can have them represent their organization, so they walk this fine line. Certification creates a space where people from the community who want to do this as a profession can meet and perform certain services for a health care organization and meet whatever liability standards that organization has. The community health worker understands how to provide health education, and that they’re not going to put in their own bias. But you also have plenty of people who work outside of that space who don't want to have anything to do with that and choose not to be certified.

How important is it for a patient with cancer to work with a community health worker who is certified versus someone who is not certified?

Patients, to a certain degree, want a health care provider that is interested in them and cares for them regardless of how many pieces of paper they have on the wall. To a certain degree, a patient may come to a doctor because they're world renowned. They have all these certificates and things like that, but a patient stays with that doctor because they trust them. It's the same thing for the community health workers. You know, it may be a brand where patients will say, “Oh, wow, community health workers are going to help me navigate through the process, and they're certified.” Most people likely didn’t even know that existed.

But at the same time, they can have that certificate, but it's going to come down to the community health worker and that bond that they create with the patient. As people go through the process, it’s important that you don't minimize community health workers that are not certified, because at the end of the day that paper doesn't create the bond. Having the certification gives health care organizations that confidence that this isn't just a person they pulled off the street, or something like that. But it just opens the door for that community health worker to start to create that bond. What takes the community health worker the rest of the way is their knowledge and their training.

What I have found is that certification has brought the profession an idea of education, because before, it was just your neighbor, it was someone who was trying to help. Sometimes you had a volunteer working at the clinical level, but they didn't have enough training. So, sometimes they might say something that was out of order. And they didn't understand that they shouldn't have made copies of the patient file and handed it to anyone. That's the most important thing that certification has brought to community health workers is that advantage of being able to participate in training and education that was not available to them before certification, because training is a part of the certification.