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Wellness Navigators
Wellness Navigators is a chronic disease prevention strategy based on the Community Health Worker (CHW) model which has been shown to be successful in reducing chronic disease, lowering health care costs, promoting healthy choices and increasing health literacy. Wellness Navigators are peer educators and coaches, working to engender healthier behaviors. They are effective because they know the communities they serve and focus on hard to reach populations that may be resistant to change.
The Navigators program uses a peer to peer relationship model. Workers are identified from within the target population. Through empathetic relationships they can promote healthy living. For example, preparation of healthy meals rather than foods high in fats, added sugars, salt and caffeine. They will offer helping knowledge about injury prevention, breast feeding, relationships and access to the formal health and social service systems at an early point in the onset of evolving issues. In this way they drive health decision making down the chain of command to the educated consumer. The Navigators program will also offer low-skilled or unemployed workers the opportunity to explore new occupational choices thereby providing an entry level economic development incentive.
Navigators may also provide a tracking mechanism for identified high risk consumers, encouraging behavior change and appropriate utilization of prescribed services on a regular basis and feedback to designated providers. In this way life styles and practices are modified by consumers prior to onset or deepening of chronic disease or behavioral outcomes. An important example is diabetes where evidence has shown that healthy dietary practices can lower the risk of onset. In a culture awash in media promoting unhealthy foods, beverages and products[1], Navigators are an important prevention strategy illuminating healthier behaviors that cannot cost effectively be provided by the formal health care system.
What is the problem?
The US is facing an epidemic of chronic disease, much of which has been shown to be linked to dietary, fitness, medication and substance abuse behaviors[2] Unless this path is altered, the formal medical care system will be financially overwhelmed.
How do we respond to this problem when there is dire shortage of primary health care providers?
Navigators can help fill an important access gap in the delivery system. As extensions of community clinics or primary care teams they can prevent unnecessary reliance on costly emergency department, outpatient and specialty services. They can also provide early detection of emerging health and social service problems. Working out in the community they will provide support for change that does not exist in the standard health care model.
Despite abundant health programs and services, many consumers do not access or use these services appropriately. Dr. Richard Carmona, former Surgeon General of the US, stated recently on the PBS Newshour, "there's a lack of health literacy in our nation." Wellness Navigators can penetrate these barriers due to their peer status and everyday connection with target consumers. For example child and family Navigators will work directly to connect young mothers to regional child and family centers encouraging participation in clinics, educational workshops and behavioral forums and provide engaged follow through with prescribed practices. Senior Navigators encourage seniors to join socialization programs, senior day centers and wellness clinics before disabilities become acute.
How does the Navigators solution work?
Many countries have used lay health workers for many years to deliver health promotion and education services. They are a prominent component of the health care systems in Australia, Great Britain and Canada. Our proposal offers a workable solution based on the experience of over 200 similar programs carried out in the US, many with dramatic health impacts on the populations served.
The 2007 HRSA Community Health Worker National Workforce Study found an array of benefits including decreases in emergency room visits, reductions in hospitalizations for target populations and fewer complications when patients do receive medical attention. It also found that CHW services are cost effective and culturally sensitive, eliminating barriers that prevent timely receipt of services and care. This study determined there were at least 600 such programs using 12,500 advisors in the US. While many programs related to specific diseases including cancer and cardiovascular disease, there were programs that dealt broadly with health promotion and disease prevention, domestic violence and injury. Some programs have been very comprehensive dealing with families holistically without categorical restrictions. Reports indicate that CHW outreach is being actively developed in Massachusetts including a training program through their community college system. We plan to integrate our program with those efforts.
Wellness Navigators will be recruited from and indigenous to the target population with which they work. They may be under or unemployed individuals who have been educationally disadvantaged. They will be identified through an appropriate interview process and provided with an ongoing subsidized training program that offers basic wellness and public health knowledge. In some locations they may have a linkage with a community health resource facility such as the Vermont PATCH Network to facilitate healthy behavioral change, early detection and linkage to an array of health and social service providers. Navigators will be provided with a living and housing subsidy, operating much like the national VISTA service program. A time commitment of one or two years will be required in exchange for the training. Navigators will be encouraged to continue their education in a field of interest following the term of service.
Goals:
The goals of this initiative are to develop a cost effective model that:
- Promotes community wide wellness practices;
- Improves population wide health literacy;
- Has a constraining impact on chronic care costs.
The purpose of the "Wellness Navigators" proposal is to address these needs by offering wellness promotion and health literacy programs to help communities become healthier using existing community social networks as outreach channels.
Summary: Wellness Navigators, acting as Community Health Workers, promote healthy living by serving as liaisons between community residents and health care and social service professionals. Navigators may make home visits, refer residents to doctors and clinics, translate between residents and their health care providers, and inform residents about the social services that are available to them. They may also make presentations on health and wellness issues, chronic disease management, parenting, and other issues related to the well-being of the family and community. They may give talks at schools, churches, private homes, and community centers and serve as resources for their neighbors. They will be trained to answer common questions and followup through resources at the neighborhood health center with which they are affiliated. |
Significant effectiveness of Navigators may result because:
- they are focused on hard-to-reach populations;
- they usually are indigenous to the target population; and
- their expertise is first hand knowing their communities and their needs.
Reinventing Health does not provide healthcare or direct health services.
For more information about this program,
please contact us.