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Past Research
For more information, contact Dr. Marjie Mogul, MCC's Director of Research.
Community Health Workers Effectiveness
Community health workers (CHWs) are known by various titles - family advocates, paraprofessionals, lay health advisors, outreach workers, promadores. The definition common to all of the job titles is neighborhood peer without master-level training.
| Community health workers (CHWs) have worked successfully with parents to increase immunization coverage and primary care. Rodewald et al (1999) found that CHWs providing immunization tracking and outreach increased immunization rates, decreased immunization delays and increased the number of well baby visits. |
| Crivelli-Kovach, Becker, and Worley (2004) evaluated the impact of a home visiting program on clients’ perceived level of empowerment. Results showed that the MOMobile program significantly increased clients’ self-sufficiency, enhanced clients’ ability to set goals, and strengthened clients’ decision-making skills. |
| In a randomized clinical trial with Latina women, Navarro et al (1998) found CHWs to be effective in increasing the numbers having a mammogram and reporting performance of breast self-exams. |
| Cooley and Unger found that support provided by CHWs in the form of emotional encouragement, advice, and financial assistance led to decreased aggressive behaviors in adolescent mothers (cited in Prater, 1995). |
| Gardner et al (2003) found that an early CHW intervention with low birthweight term infants addressing maternal-child interaction improved infant problem solving, cooperativeness, and mood. |
| An evaluation of a smoking cessation program for Latinos (Woodruff, 2002) demonstrated that CHWs improved abstinence rates in the short term. |
| Kim et al (2004) found that classes on nutrition, physical activity, and maintaining smoke-free environments taught by CHWs showed significant increases in lifestyle behavior change. |
| The national evaluation of the Early Head Start program (2001), which utilizes CHWs, found that two-year old EHS children performed better on a range of measures of cognitive, language and social-emotional development than the control group. |
References
Commissioner's Office of Research and Evaluation and the Head Start Bureau. (2001). Building their futures: How Early Head Start programs are enhancing the lives of infants and toddlers in low-income families, Summary Report. Administration on Children, Youth and Families, Department of Health and Human Services.
Crivelli Kovach A, Becker J, & Worley H. (2004). The impact of community health workers on the self-determination, self-sufficiency, and decision-making ability of low income women and mothers of young children. Journal of Community Psychology 32(3), 343-356.
Kim S, Koniak-Griffin D, Flaskerud JH, Guarnero PA. (2004). The impact of lay health advisors on cardiovascular health promotion: Using a community-based participatory approach. Journal of Cardiovascular Nursing 19(3):192-199.
Navarro A, Senn K, McNicholas L, Kaplan R, Roee B, & Campo M. (1998). Por La Vida model enhances use of cancer screening tests among Latinas. American Journal of Preventive Medicine, 15(1), 32-41.
Prater, L.P. (1995). Never married/biological ten mother headed household. Marriage and Family Review 20(3/4), 305-324.
Rodewald, L.E. MD., Szilagyi, P.G., MD., Humiston, S.G., MD., Barth, R., Kraus, R. & Raubertas, R.F. (1999). A randomized study of tracking with outreach and provider prompting to improve immunization coverage and primary care. Pediatrics. 1999:103:31-38.
Woodruff SI, Talavera GA, & Elder JP. (2002). Evaluation of a culturally appropriate smoking cessation intervention for Latinos. Tobacco Control, 11(4):361-367.
MOMobile Makes a Difference: Empowerment Study
MCC researched the role of community health workers in empowering low-income women. Results from this study showed that client "empowerment", defined as the combination of self-perceived decision-making, self-sufficiency and self-determination, improved over time with MOMobile services. Two articles were published in the May, 2004 issue of the Journal of Community Psychology, Vol. 32, No. 3
- The Impact of Community Health Workers on the Self-Determination, Self-Sufficiency, and Decision-Making Ability of Low-Income Women and Mothers of Young Children
- Individual Empowerment: How Community Health Workers Operationalize Self-Determination, Self-Sufficiency, and Decision-Making Abilities of Low-Income Mothers
Maternity Care Coalition's Empowerment Study
This study evaluated the impact of the MOMobile on clients' perceived level of empowerment. Published results show that the MOMobile significantly:
- Increases clients' self-sufficiency
- Enhances clients' ability to set goals
- Strengthens clients' decision-making skills
Crivelli Kovach A, Becker J, & Worley H. (2004) Journal of Community Psychology
Food Stamp Participation Project
The goal of the Food Stamp Participation Project, a two-year research project funded by the U.S. Department of Agriculture, was to increase participation among low-income families in the federal Food Stamp Program. Working in Delaware and Montgomery counties, MCC explored what supports were necessary to facilitate application and enrollment. Information was collected by pre-screening clients, providing application assistance, and conducting focus group discussions. Findings revealed that language and low literacy barriers contributed substantially to lack of participation in the Food Stamp Program, and that staff assistance was necessary to facilitate application for the majority of people. Neither education alone nor education combined with prescreening was sufficient to motivate most clients to apply for the FSP.
Healthy at Home
With funding from the Office of Minority Health of the U.S. Department of Health and Human Services, MCC developed a two-year educational, community based, integrated environmental health program for families of very young children to address health disparities that affect Latino and African American residents of North Philadelphia. The goal of Healthy at Home was to reduce the environmental health risks of lead poisoning, asthma triggers, tobacco smoke pollution, toxic household products and pests to low income families through their participation in a comprehensive intervention provided by community health workers. Through "bucket" home visits and follow up visits and phone calls, MCC community health workers provided each participant with materials, information, support, practical tools, and resources to improve the health of her family and to help reduce the environmental health disparities found in the minority populations of North Philadelphia. An analysis of data collected from participants during the two year program demonstrated that there was an increase in knowledge for each content area. Significant positive changes in behaviors such as using cold water for cooking, increased hand washing and using non-chemical cleaners were concurrent with the increase in knowledge.
Smoke Free Moms
Funded by the Delaware County Office of Behavioral Health, Smoke Free Moms is an intensified smoking cessation intervention using CO monitors to provide biofeedback on tobacco exposure as well as a mechanism for smoking cessation support. Findings from Delaware County reveal that, in 2003, 56% of clients changed their smoking behavior: 16% have quit; 12% have reduced; and 28% have moved their smoking away from young children.
Postpartum Depression
Postpartum depression is a serious and common mental health problem. Approximately 10-15% of women develop non-psychotic depression after childbirth. In spite of the frequency of occurrence, the depression of many women goes undetected. Low income families are a particularly vulnerable group, because the mothers have increased rates of depression. MCC recently partnered with a clinical psychologist at the Children's Hospital of Pennsylvania (CHOP) on a study to assess a postpartum screening tool, the Postpartum Depression Screening Scale (PDSS), in a community sample of low-income, ethnically diverse postpartum women. Seventy-five MOMobile clients participated in this study from September 2004 through August of 2005.
For more information contact:
Marjie Mogul, PhD
Director of Research
215-989-3575
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