Background: Health disparities and issues with trust building and relationship building are prominent in Hispanic and underserved populations in south Texas. Community health workers can play a bridging role with underserved communities and may be essential in improving the quality and value of health care. The Texas Health and Human Services Commission certifies the training Community Health Workers under the label of “promotores”.
Method: Community health workers were integrated into the primary health care team to serve as a bridge between patient/caregiver dyads and the health care team.
Result: Community health workers (CHWs) connected patients to social determinants of health resources such as transportation, food pantries and/or social benefits, Medicaid services, and home care provider services. Caregiver education and resources for respite care, caregiver support in person and virtually. Additionally, CHW's provided education on dementia care resources, caregiver support, recruiting and engaging Hispanic underserve participants in research. Our team was able to increase home visits by 229% to homebound patients throughout several underserved zip codes in Bexar County. This is a success as our team was able to increase health care access to persons with dementia that are homebound that may have not been seen by a healthcare provider until they required emergency care. In fact, we saw roughly 11% decrease of inpatient admissions between 2021 and 2022.
Conclusion: Trust and familiarity allows the promotores to easily communicate interventions with cultural sensitivity and experiential knowledge of community values, leading to foster rapport with patients and families. The rapport and trust developed with the patients also helped to engage, and recruit Hispanic and underserved participants for research in dementia.
Patel NK, De La Garza- Parker C, ; Davila A; Garza N, Goss M, Satizabal CL, de Erausquin GA, Maestre GE, and Seshadri S, (2023) An innovative model using Promotores or Community Health Workers for home-based dementia care. Alzheimer’s Association International Conference.
Alzheimer’s Association International Conference