Health disparities are well established and documented among vulnerable and underserved populations, including refugees and American Indians. San Diego is a hub for refugee resettlement from around the globe where it is the 2nd largest concentration of Somali and Middle Eastern immigrants in the US. Further, American Indians in California are for the large part living in urban areas in major cities and suffer from inadequate health care and health inequities. A recent household survey of refugee communities by our partners demonstrated disparities in health literacy and social determinants of health that result in members of these communities being underserved and at risk for negative health outcomes. Our goals from this proposal to increase the Community Health Worker (CHW)/Health Support Worker (HSW) workforce among this community, by developing curricular options for CHWs/HSWs specifically designed to meet the needs of target communities in public health education and services including COVID-19 and expand and improve the quality of the workforce of CHWs/HSWs providing healthcare support, public health services to influence health inequities. We will achieve these goals by implementing the following objectives: 1. Recruit qualified community members to become CHWs/HSWs from and serving our target refugees and American Indian communities. 2. Develop CHW and HSW curricula that are culturally sensitive and meet the public health needs – including COVID-19 – of our target population. 3. Update, adapt, and continuously improve CHW and HSW curricula. 4. Train community health workers and health support workers to serve the communities they come from in a culturally appropriate manner. 5. Provide placement and apprenticeship experiences for graduates of the training program. 6. Conduct program evaluation to examine program quality and impact and to support program sustainment. We have built an exceptional consortium of an academic-community partner
ship with regional clinical health services to fulfil the training and placement of CHW/HSW to address public health needs of their communities and especially with regards to COVID-19. The partners are Somali Family Service (SFS), San Diego Refugee Communities Coalition (SDRCC), the Union of Pan Asian Communities (UPAC), the California Coalition for Urban Indian Health (CCUIH), San Diego Workforce Partnerships (SDWP), Family Health Centers of San Diego (FHCSD), Health Center Partners of Southern California (HCPSC), and the Hospital Association of San Diego & Imperial County (HASD&IC). The Community organizations (i.e., SFS, SDRCC, UPAC, CCUIH) will focus on recruitment and be involved in the training, while the clinical collaborators (FHCSD, HCPSC, & HASD&IC) and the main on-the-job training organization SDWP will provide placements and apprenticeships for the trainees. We will also place trainees in community-based organizations through our community organizations and their networks. We will follow up with systemic evaluation of the program after the first year and adapt and refine the features of the program based on this evaluation to create a culturally appropriate and community-responsive training experience for CHW/HSW related to public health topics such as COVID-19 vaccine, emergency response education, prevention, treatment, and vaccine hesitancy research, or prevention of common illnesses. Before the end of the program, we will initiate sustainability measures such as applying for further state funding to continue the apprenticeship support and provide reduced tuition fees to keep the courses running for future CHWs. Total of 3 million dollars is requested to fulfil this program. This is a unique approach involving diverse partners coming together to serve the needs of underserved and vulnerable refugee and American Indian communities in San Diego and the region, to fill in the gap of health care and address health inequities among these
populations.